Provider Demographics
NPI:1255431995
Name:WHITE, JON CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:CHARLES
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1350 CONNECTICUT AVE NW
Mailing Address - Street 2:STE 1225
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1718
Mailing Address - Country:US
Mailing Address - Phone:202-850-0578
Mailing Address - Fax:202-836-6921
Practice Address - Street 1:1350 CONNECTICUT AVE NW
Practice Address - Street 2:STE 1225
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1718
Practice Address - Country:US
Practice Address - Phone:202-850-0578
Practice Address - Fax:202-836-6921
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD16709208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care