Provider Demographics
NPI:1326199167
Name:BETHEA, WILLIAM W (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:BETHEA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3600 PRYTANIA ST
Mailing Address - Street 2:SUITE 35
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3628
Mailing Address - Country:US
Mailing Address - Phone:504-897-8315
Mailing Address - Fax:504-891-9862
Practice Address - Street 1:3434 PRYTANIA ST
Practice Address - Street 2:SUITE 130
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3532
Practice Address - Country:US
Practice Address - Phone:504-897-7850
Practice Address - Fax:504-897-8556
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2014-01-21
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Provider Licenses
StateLicense IDTaxonomies
LA04525R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1197114Medicaid
LA1197114Medicaid
LA5M388D516Medicare PIN
LA16005468Medicare PIN