BENNIE R. WHITE JR. (NPI# 1376575225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376575225 |
| Entity Type | Individual |
| Full Name | BENNIE R. WHITE JR. |
| Credential | MD |
| Practice Address |
794 Mcdonough Rd Suite 105 Jackson GA 30233-1572 |
| Practice Telephone | 7707752341 |
| Practice Fax Number | 7707753668 |
| Mailing Telephone | 7707752341 |
| Mailing Fax Number | 7707753668 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 056245 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 345029068A | 05 |
| Street Address |
794 MCDONOUGH RD SUITE 105 |
| City | JACKSON |
| State | GA |
| Zip Code | 30233-1572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558330522 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 794 Mcdonough Rd, Jackson, GA 30233-1572 | 2006-03-14 |
| 1740755719 | Byron A Thompson | Counselor | 794 Mcdonough Rd, Jackson, GA 30233 | 2018-10-05 |
| 1750789947 | Select Interventional Pain, PC | Pain Medicine | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2014-12-20 |
| 1306126529 | Jaimi Marie Norrell | Nurse Practitioner | 794 Mcdonough Rd, 111, Jackson, GA 30233-1572 | 2011-08-18 |
| 1992943195 | Dana B Bass Burch | Physician Assistant | 794 Mcdonough Rd, Suite 111, Jackson, GA 30233-1572 | 2009-01-26 |
| 1093963944 | South Georgia Treatment, Inc | Clinic/Center | 794 Mcdonough Rd, Jackson, GA 30233-1572 | 2008-09-04 |
| 1306019104 | Bennie R White Jr Md Inc | Clinic/Center | 794 Mcdonough Rd, Suite 105, Jackson, GA 30233-1572 | 2008-04-12 |
| 1306025630 | Derrell Levohn Leggett | Anesthesiology | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2007-11-02 |
| 1033329198 | Jackson Dialysis Center | Clinic/Center | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1306225057 | Young Dreaden | Nurse Practitioner | 2978 Hwy 36w, Jackson, GA 30233 | 2015-05-28 |
| 1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
| 1033546098 | Henrietta Lindsay | Social Worker | 463-b Ernest Biles Dr, Jackson, GA 30233 | 2013-10-04 |
| 1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
| 1730489592 | Mary L. Melton | Licensed Practical Nurse | 463 Ernest Biles Dr., Jackson, GA 30233 | 2010-10-27 |
| 1083864250 | Chastity Moore Brown | Dentist | 1520 Lucky Street, Griffin, GA 30233 | 2008-09-24 |
| 1568661320 | Joseph Fowlkes | Internal Medicine | 2978 Highway 36 W, Jackson, GA 30233 | 2007-07-12 |
| 1942386289 | Butts County Board of Commissioners | Ambulance | 154 Sylvan Drive, Jackson, GA 30233 | 2006-10-30 |
| 1841238300 | Jackson Pharmacy Services | Pharmacy | 22 Mulberry St., Jackson, GA 30233 | 2006-06-04 |
| Find all providers in zip 30233 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1003470758 | Central Mississippi Health Services, Inc | Family Medicine | 3450 Highway 80 W Ste 71, Jackson, MS 39209-7201 | 2019-04-29 |
| 1922515493 | Meaghan Schenk Johnson | Family Medicine | 2969 Curran Dr N # 200, Jackson, MS 39216-4121 | 2018-01-05 |
| 1740795731 | Emily Colleen Dunaway | Family Medicine | 1227 N State St # 101, Jackson, MS 39202-2002 | 2017-12-12 |
| 1679086367 | Hope Np House Call Practice | Family Medicine | 98 Grandview Ave, Jackson, OH 45640-9090 | 2017-11-16 |
| 1427585488 | Daniel Matthew Bender | Family Medicine | 455 W Broadway Ave, Jackson, WY 83001-8639 | 2017-05-21 |
| 1891235289 | Logan Hardin | Family Medicine | 1270 Union University Dr Ste A, Jackson, TN 38305-3856 | 2017-03-03 |
| 1255782843 | Seth Tyler Koehler | Family Medicine | 2600 E Main St, Jackson, MO 63755-2473 | 2016-06-25 |
| 1720495245 | Gopi Patel | Family Medicine | 27 S Cooks Bridge Rd Ste 2-1, Jackson, NJ 08527-2524 | 2014-07-16 |
| 1154735165 | Lk Physicians Services Pllc | Family Medicine | 36 Lake Pointe Dr, Jackson, TN 38305-8113 | 2014-06-17 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.