Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 204614 | LA |
N | 207X00000X | Orthopaedic Surgeon | PGY-1 INTERN PERMIT | LA |
NPI | 1013178284 |
---|---|
Provider Name | Dr. Jeffrey Bingham Witty |
First Address | Hammond, LA 70404-2668 |
Second Address | Hammond, LA 70403-1431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2008 |
Last Update Date | 19/07/2019 |