Provider Demographics
NPI:1124016985
Name:MARANTO, WILLIAM F (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:MARANTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2539 VIKING DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2165
Mailing Address - Country:US
Mailing Address - Phone:318-747-8100
Mailing Address - Fax:318-747-8152
Practice Address - Street 1:2539 VIKING DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2165
Practice Address - Country:US
Practice Address - Phone:318-747-8100
Practice Address - Fax:318-747-8152
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA024993207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1423262Medicaid
LA1423262Medicaid
LA4F318Medicare ID - Type Unspecified