Provider Demographics
NPI:1770562647
Name:APPLEWHITE, GEORGE ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ARTHUR
Last Name:APPLEWHITE
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:PO BOX 1729
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39403-1729
Mailing Address - Country:US
Mailing Address - Phone:601-545-3700
Mailing Address - Fax:601-450-2493
Practice Address - Street 1:1911 READ RD
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-2730
Practice Address - Country:US
Practice Address - Phone:601-251-3500
Practice Address - Fax:601-251-3504
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS076202083P0901X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01900556Medicaid
MS11822529OtherCAQH ID NUMBER
MS01900556Medicaid
MSD73545Medicare UPIN