Most Relevant Information
Provider Data
| NPI Number: | 1003816943 |
| Provider Name: | MARTIN R. WHITE O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 18002542B |
Most Important Dates
| Enumeration Date: | 07/21/2005 |
| Last Updated: | 02/24/2010 |
Provider Practice Location
6110 MAPLECREST RD
FORT WAYNE
IN
468352524
Practice Location Phone/Fax
| Phone: | 2604868833 |
| Fax: | 2604868784 |
Provider Mailing Location
6110 MAPLECREST RD
FORT WAYNE
IN
468352524
Provider Mailing Phone/Fax
| Phone: | 2604868833 |
| Fax: | 2604868784 |