Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | MD.014611 | LA |
NPI | 1194728600 |
---|---|
Provider Name | William Felder Beacham |
First Address | Hammond, LA 70403-1446 |
Second Address | Hammond, LA 70403-1446 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2005 |
Last Update Date | 22/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1320625 | (05) | LA |
B60705 | (02) | LA |