Provider Demographics
NPI:1790119121
Name:WILLIAM J WOESSNER, MD
Entity Type:Organization
Organization Name:WILLIAM J WOESSNER, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOESSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-525-5262
Mailing Address - Street 1:750 CAMP ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-3702
Mailing Address - Country:US
Mailing Address - Phone:504-525-5262
Mailing Address - Fax:504-524-4671
Practice Address - Street 1:750 CAMP ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-3702
Practice Address - Country:US
Practice Address - Phone:504-525-5262
Practice Address - Fax:504-524-4671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA012046261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care