Provider Demographics
NPI:1457526089
Name:DR.WILLIAM C. CONEY
Entity Type:Organization
Organization Name:DR.WILLIAM C. CONEY
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:C
Authorized Official - Last Name:CONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-339-6162
Mailing Address - Street 1:904 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71343-2108
Mailing Address - Country:US
Mailing Address - Phone:318-339-6162
Mailing Address - Fax:318-339-6719
Practice Address - Street 1:904 FIRST ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71343-2108
Practice Address - Country:US
Practice Address - Phone:318-339-6162
Practice Address - Fax:318-339-6719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10893261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1106488Medicaid
LAB63094Medicare UPIN