TW White OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2104 Issued in MO

Legal business name

TW WHITE OD PC

Practice address

410 W Hayward Dr
Mount Vernon, MO 65712-7368

Phone

(417) 466-2100

Fax

(417) 466-0432

NPI assigned

Feb 11, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. T W White, O.D.

Title

Optometric Doctor

Phone

(417) 466-2100

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1851623185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 311",
            "address_2": "410 W HAYWARD DR",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657120311",
            "telephone_number": "417-466-2100",
            "fax_number": "417-466-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W HAYWARD DR",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657127368",
            "telephone_number": "417-466-2100",
            "fax_number": "417-466-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TW WHITE OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "T",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OPTOMETRIC DOCTOR",
        "authorized_official_telephone_number": "417-466-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310151006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April R Swanson
• Clayton Earl Thompson, PHARMD
• Three Rivers Hospice Inc
• Thrive Therapy Solutions, LLC
• TW White OD PC
• Kusai A Umran, MD
• Megan Caroline Vanderbush, COTA
• Gail M Vaughn, RPH
• Wal-Mart Stores East LP
• Mark Vincent Walters, D.C.

• Optometrist in Mount Vernon, MO
• Providers in Mount Vernon, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.