Healthcare Provider Details

I. General information

NPI: 1194728600
Provider Name (Legal Business Name): WILLIAM FELDER BEACHAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2005
Last Update Date: 03/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15748 MEDICAL ARTS DR
HAMMOND LA
70403-1446
US

IV. Provider business mailing address

15748 MEDICAL ARTS DR
HAMMOND LA
70403-1446
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-0663
  • Fax: 985-542-7010
Mailing address:
  • Phone: 985-542-0663
  • Fax: 985-542-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD.014611
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: