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DR. JACKIE R WHITE MD
NPI 1417964107
Family Medicine in Imboden, AR

Active since August 02, 2006
201 N WALNUT, IMBODEN, AR 72434(870) 869-3101(870) 869-3014 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jackie R White Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACKIE R WHITE MD (NPI 1417964107) is an individual family medicine provider in Imboden, Arkansas, licensed in Arkansas (C5252) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1417964107
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JACKIE R WHITECredential: MD
Location Address201 N WALNUTImboden, AR 72434
Mailing AddressPo Box 128, 201 N WalnutImboden, AR 72434 · (870) 869-3101 · Fax (870) 869-3014
Phone(870) 869-3101
Fax(870) 869-3014
Sole ProprietorNo
Enumeration DateAugust 2, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1417964107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AR · C5252
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
201 N WALNUT, Imboden, AR 72434
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Other Identifiers 4

Medicare UPIND17173
Medicare ID-Type Unspecified55630AR
Other710836669002Prudential
Other7182132Aetna

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackie White's NPI number?

The NPI number for Jackie White is 1417964107. It was assigned to this individual provider in the NPPES registry on August 2, 2006.

Where is Jackie White located?

Jackie White practices at 201 N Walnut, Imboden, AR 72434. The listed phone number is (870) 869-3101.

What is Jackie White's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Jackie White was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.