Provider Demographics
NPI:1447667753
Name:WHITE, WILLIAM JR (PA-C)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:WHITE
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S RIVER RD UNIT D2
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6734
Mailing Address - Country:US
Mailing Address - Phone:603-450-0111
Mailing Address - Fax:888-992-0918
Practice Address - Street 1:116 S RIVER RD UNIT D2
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6734
Practice Address - Country:US
Practice Address - Phone:603-450-0111
Practice Address - Fax:888-992-0918
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
VA0110004753363A00000X
FLPA9116331363AM0700X
DEC5-0011777363AM0700X
CT5863363AM0700X
MEPA2357363AM0700X
MAMCS002474J363AM0700X
NH1387363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant