MEDICARE: WILLIAM R GUILLORY JR. M.D., F.A.C.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	016627	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649262916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM R GUILLORY JR. M.D., F.A.C.C.

Provider Business Mailing Address
First Line	:	155 HOSPITAL DR
Second Line	:	SUITE 203
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2852
Country	:	US
Telephone Number	:	337-236-3411
Fax Number	:	337-236-3118

Provider Business Practice Location Address
First Line	:	155 HOSPITAL DR
Second Line	:	SUITE 203
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-2852
Country	:	US
Telephone Number	:	337-236-3411
Fax Number	:	337-236-3118

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	07/08/2007

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