Basic Information
| Provider Information | |||||||||
| NPI: | 1033684519 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHITE | ||||||||
| FirstName: | SCARLETT | ||||||||
| MiddleName: | |||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7060 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852467060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804442017 | ||||||||
| FaxNumber: | 4805457181 | ||||||||
| Practice Location | |||||||||
| Address1: | 3331 E BASELINE RD | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852342633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804442017 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2018 | ||||||||
| LastUpdateDate: | 10/30/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 7247 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.