Gordon Ellis White in Danville - Military Health Care Provider
Gordon Ellis White - NPI 1639169485
Gordon Ellis White is a Military Health Care Provider in Danville, Illinois. Gordon Ellis White practices all healthcare services and medical treatments related to Military Health Care Provider. The NPI Number for Gordon Ellis White is 1639169485. The last update date is 2021-06-08.
Gordon Ellis White's current location address is 1900 E Main St, Danville, Illinois. You can contact this provider via phone number 3188014070 and fax number 3185544807. The mailing address for Gordon Ellis White is 1900 E Main St, Danville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gordon Ellis White |
|---|---|
| Address | 1900 E Main St, Danville, Illinois |
| Phone Number | 3188014070 |
| Fax Number | 3185544807 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1639169485 |
|---|---|
| Provider Enumeration Date | 2005-10-24 |
| Last Updated Date | 2021-06-08 |
Provider Mailing Address Detail
| Address | 1900 E Main St |
|---|---|
| City | Danville |
| State | Illinois (IL) |
| Post Code | 618325100 |
| Phone Number | 3188014070 |
| Fax Number | 3185544807 |
Provider's Primary Taxonomy Detail
| Speciality | Military Health Care Provider |
|---|---|
| Taxonomy | 171000000X |
| Licence No | 25398 |
|
Definition: Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1423688 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Gordon Ellis White by the Centers for Medicare & Medicaid Services?
The Gordon Ellis White has been assigned the NPI (National Provider Identifier) 1639169485 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Gordon Ellis White located?
The Gordon Ellis White is located at 1900 E Main St, Danville, IL 618325100.
What is Gordon Ellis White's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Gordon Ellis White is Military Health Care Provider, and the taxonomy classification code that categorizes this area of expertise is 171000000X.
When did the Gordon Ellis White receive its 1639169485?
The Gordon Ellis White was issued its 1639169485 on 2005-10-24, which is the date when the organization was assigned this unique identifier.
As of what date were the Gordon Ellis White's details last updated?
The information pertaining to the Gordon Ellis White, including its address, specialty, and other details, was most recently updated on 2021-06-08.
NPI Number: 1528061710
Address: 19 Nh Route 104, Meredith, NH