Mallory D White (NPI# 1124411749, PAC ID# 8628385333) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1124411749 |
| PAC ID by PECOS | 8628385333 |
| Professional Enrollment ID | I20150914000390 |
| Full Name | Mallory D White |
| Organization Legal Name | OSUMC PROFESSIONAL SERVICES LLC |
| Address |
1205 W Main St Collinsville OK 74021-3114 |
| Phone Number | 9189380040 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9234254012 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1205 W Main St, Collinsville, OK 74021-3114 | 9189380040 | OSUMC PROFESSIONAL SERVICES LLC |
| 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 | 9187488111 | OSUMC PROFESSIONAL SERVICES LLC |
| Organization Legal Name | OSUMC PROFESSIONAL SERVICES LLC |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tara B Hasenpflug | Family Medicine | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 |
| Lori Edwards | Certified Nurse Midwife (cnm) | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 |
| Carolyn J Steele | Family Medicine | Osumc Professional Services LLC | 1205 W Main St, Collinsville, OK 74021-3114 |
| John Hervert | Internal Medicine | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 |
| Nadim N Daher | Pulmonary Disease | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 |
| Marinn Rank | Family Medicine | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 210, Tulsa, OK 74127-9047 |
| Chelsey Diane Griffin | Family Medicine | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 |
| Ahmad Khattab | Pain Management | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 |
| Lindsey R Norman | Nurse Practitioner | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 |
| Joseph E Wolf | Family Medicine | Osumc Professional Services LLC | 802 S Jackson Ave, Suite 310, Tulsa, OK 74127-9057 |
| Street Address |
1205 W MAIN ST |
| City | COLLINSVILLE |
| State | OK |
| Zip | 74021-3114 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carolyn J Steele | Family Medicine | Osumc Professional Services LLC | 1205 W Main St, Collinsville, OK 74021-3114 |
| Constance Ann Rogers | Family Medicine | Osumc Professional Services LLC | 1205 W Main St, Collinsville, OK 74021-3114 |
| Jerry D Patton | Family Medicine | Osumc Professional Services LLC | 1205 W Main St, Collinsville, OK 74021-3114 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leonard D Hart | Optometry | Len D Hart O D, 1103 W, Collinsville, OK 74021 | |
| Deena Elysse Winham | Physical Therapy | Redbud Physical Therapy LLC | 707 W Main St, Collinsville, OK 74021-3226 |
| John Christopher Ahrens | Physical Therapy | Redbud Physical Therapy LLC | 707 W Main St, Collinsville, OK 74021-3226 |
| Joshua David Kelley | Physical Therapy | Redbud Physical Therapy LLC | 707 W Main St, Collinsville, OK 74021-3226 |
| City | COLLINSVILLE |
| Zip Code | 74021 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | COLLINSVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Mallory D White.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.