Provider Demographics
NPI:1174739494
Name:WHITE, LINDA LEE (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 RICHLAND RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6717
Mailing Address - Country:US
Mailing Address - Phone:740-389-4485
Mailing Address - Fax:740-389-4485
Practice Address - Street 1:913 BOWMAN ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-4109
Practice Address - Country:US
Practice Address - Phone:419-755-3202
Practice Address - Fax:419-522-9802
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-5388W207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine