Bennie R White Jr MD INC

NPI #1306019104 in Jackson, Georgia

Provider Information

NPI Number
1306019104
Entity Type
Organization
Organization Name
Bennie R White Jr MD INC
Primary Specialty
Clinic/Center - Primary Care
Enumeration Date
Apr 12, 2008
Last Updated
Apr 12, 2008

Practice Location

Address
794 MCDONOUGH RD
Address 2
SUITE 105
State
Georgia
ZIP Code
30233-1572
Phone
(770) 775-2341

Authorized Official

Name
DR. BENNIE RUSSELL WHITE JR., MD
Title
PRESIDENT
Phone
(770) 775-2341

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Primary CarePrimary Care

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