Provider Demographics
NPI:1598916330
Name:BEARD, WILLARD W (PA-C)
Entity Type:Individual
Prefix:
First Name:WILLARD
Middle Name:W
Last Name:BEARD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3200 MONROE HWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-8110
Mailing Address - Country:US
Mailing Address - Phone:318-640-3737
Mailing Address - Fax:318-640-3740
Practice Address - Street 1:3200 MONROE HWY
Practice Address - Street 2:SUITE 105
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-8110
Practice Address - Country:US
Practice Address - Phone:318-640-3737
Practice Address - Fax:318-640-3740
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAPA A10447363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant