MEDICARE: WILLIAM SYDNEY WHYTE II 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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	14038R	LA
2	208VP0014X	Interventional Pain Medicine Physician	14038R	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	250013028	OTHER	LA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	7891234	OTHER	LA	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821060476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM SYDNEY WHYTE II M.D.

Provider Business Mailing Address
First Line	:	457 ASHLEY RIDGE BLVD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7229
Country	:	US
Telephone Number	:	318-221-7246
Fax Number	:	318-861-1325

Provider Business Practice Location Address
First Line	:	457 ASHLEY RIDGE BLVD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7229
Country	:	US
Telephone Number	:	318-221-7246
Fax Number	:	318-861-1325

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	09/27/2011

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Directions to “ WILLIAM SYDNEY WHYTE II M.D.” Practice Location

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