Russell William White, PA-C

NPI #1174022206 in Bradenton, Florida

Provider Information

NPI Number: 1174022206
Entity Type: Individual
Name: Russell William White, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Feb 5, 2018
Last Updated: Feb 12, 2018

Practice Location

Address: 6015 POINTE WEST BLVD
City: Bradenton
State: Florida
ZIP Code: 34209-5525
Phone: (941) 782-0200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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