Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 04174R | LA |
NPI | 1063519072 |
---|---|
Provider Name | Frederic T Billings III |
First Address | Baton Rouge, LA 70809-3482 |
Second Address | Baton Rouge, LA 70809-3482 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 22/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184471 | (05) | LA |
B61260 | (02) | LA |