Provider Demographics
NPI:1356413033
Name:WHITE, JAMES W JR (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:WHITE
Suffix:JR
Gender:M
Credentials:DC
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Mailing Address - Street 1:6070 FENTON RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-4747
Mailing Address - Country:US
Mailing Address - Phone:810-232-0670
Mailing Address - Fax:810-232-0671
Practice Address - Street 1:6070 FENTON RD
Practice Address - Street 2:SUITE 5
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-4747
Practice Address - Country:US
Practice Address - Phone:810-232-0670
Practice Address - Fax:810-232-0671
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2019-11-13
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Provider Licenses
StateLicense IDTaxonomies
MI2301004936111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4433342Medicaid
MI0B55120Medicare ID - Type Unspecified