MEDICARE: MR. WILLIAM K LO MD

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	2084P0800X	Psychiatry Physician	25494	LA

General Provider Information

NPI Number	:	1275602294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM K LO MD

Provider Business Mailing Address
First Line	:	1525 RIVER OAKS RD W
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70123-2162
Country	:	US
Telephone Number	:	985-734-1740
Fax Number	:	985-733-7020

Provider Business Practice Location Address
First Line	:	1525 RIVER OAKS RD W
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70123-2162
Country	:	US
Telephone Number	:	985-734-1740
Fax Number	:	985-733-7020

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/08/2007

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