Provider Demographics
NPI:1356392385
Name:WHITE, JULIA R (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:R
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD
Mailing Address - Street 2:COLUMBUS
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2046
Mailing Address - Fax:614-293-7443
Practice Address - Street 1:1145 OLENTANGY RIVER RD
Practice Address - Street 2:COLUMBUS
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3117
Practice Address - Country:US
Practice Address - Phone:614-688-7374
Practice Address - Fax:614-688-7356
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2017-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.0988772085R0001X
WI348102085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
002000138KOtherHUMANA
WI31973300Medicaid
WI31973300Medicaid
F68017Medicare UPIN