Provider Demographics
NPI:1821060476
Name:WHYTE, WILLIAM SYDNEY II (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SYDNEY
Last Name:WHYTE
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 ASHLEY RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-7229
Mailing Address - Country:US
Mailing Address - Phone:318-221-7246
Mailing Address - Fax:318-861-1325
Practice Address - Street 1:457 ASHLEY RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-7229
Practice Address - Country:US
Practice Address - Phone:318-221-7246
Practice Address - Fax:318-861-1325
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14038R2081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA250013028OtherRAILROAD MEDICARE
LA7891234OtherAETNA
LA1495964Medicaid
LA250013028OtherRAILROAD MEDICARE
LA7891234OtherAETNA