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1134213523
LARRY D WHITE
ALBUQUERQUE, NM
NPI
1134213523
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: NM A-112999)
Enumeration Date
2006-10-03
Last Update Date
2008-08-19
Business Address
LARRY D WHITE DO
PMG NORTHSIDE 5901 HARPER DR NE
ALBUQUERQUE, NM 87109
Phone number: 505-823-8888
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Mailing Address
LARRY D WHITE DO
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-5356
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