Provider Demographics
NPI:1518266402
Name:CLAIBORNE, WILLIAM CHARLES COLE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHARLES COLE
Last Name:CLAIBORNE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1477 LOUISIANA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3550
Mailing Address - Country:US
Mailing Address - Phone:504-895-5400
Mailing Address - Fax:504-895-3326
Practice Address - Street 1:1477 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-895-4339
Practice Address - Fax:504-899-1379
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.205449207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2150073Medicaid