| Richard A White, MD | |
|
515 E Promenade St, Mexico, MO 65265-2966 | |
| (573) 582-0157 | |
| (573) 581-4995 |
| Full Name | Richard A White |
|---|---|
| Gender | Male |
| Speciality | Sports Medicine |
| Experience | 27 Years |
| Location | 515 E Promenade St, Mexico, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770536856 | NPI | - | NPPES |
| P00239066 | Other | MO | RR MEDICARE |
| 207249301 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 2005000797 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fitzgibbon Memorial Hospital | Marshall, MO | Hospital |
| Cedar County Memorial Hospital | El dorado springs, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| John Fitzgibbon Memorial Hospital Inc. | 2567351570 | 47 |
| Entity Name | Cedar County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619090404 PECOS PAC ID: 7315841129 Enrollment ID: O20040120000314 |
| Entity Name | John Fitzgibbon Memorial Hospital Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285650176 PECOS PAC ID: 2567351570 Enrollment ID: O20080708000234 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard A White, MD Po Box 1027, Jefferson City, MO 65102-1027 Ph: (573) 681-3767 | Richard A White, MD 515 E Promenade St, Mexico, MO 65265-2966 Ph: (573) 582-0157 |
Dr. Kathleen M Weaver, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 626 E Summit St, Suite B, Mexico, MO 65265 Phone: 573-582-0444 Fax: 573-582-0438 | |
Ben L Jolly, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 515 E Promenade St, Mexico, MO 65265 Phone: 573-582-6831 Fax: 573-582-3220 |