Provider Demographics
NPI:1831331792
Name:MV WHITE INCORPORATED
Entity type:Organization
Organization Name:MV WHITE INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-273-6442
Mailing Address - Street 1:5285 W QUAIL RUN LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-7748
Mailing Address - Country:US
Mailing Address - Phone:812-801-4329
Mailing Address - Fax:
Practice Address - Street 1:2580 MICHIGAN RD
Practice Address - Street 2:SUITE A
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-2491
Practice Address - Country:US
Practice Address - Phone:812-273-6442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0937237700000X
IN17001213A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty