MEDICARE: DR. WILLIAM LANDRY BAUMGARTNER M.D.

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	207R00000X	Internal Medicine Physician	312692	LA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	208M00000X	Hospitalist Physician	312692	LA

General Provider Information

NPI Number	:	1881135101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM LANDRY BAUMGARTNER M.D.

Provider Business Mailing Address
First Line	:	1542 TULANE AVE # 444
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2865
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	75002 WOODLAND RD
Second Line	:
City	:	ABITA SPRINGS
State	:	LA
Zip	:	70420-2956
Country	:	US
Telephone Number	:	985-264-2474
Fax Number	:

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

Provider Enumeration Date	:	03/20/2017
Last Update Date	:	07/01/2020

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