Provider Demographics
NPI:1649296351
Name:WHITE, DEAN STANTON (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:STANTON
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 TURKEY CRK
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-9500
Mailing Address - Country:US
Mailing Address - Phone:352-682-4949
Mailing Address - Fax:
Practice Address - Street 1:922 E CALL ST
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-3616
Practice Address - Country:US
Practice Address - Phone:904-964-6260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87912207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79345OtherBC/BS
FLH89998Medicare UPIN
FL79345ZMedicare ID - Type Unspecified