Provider Demographics
NPI:1063729275
Name:WELDON, WILLIAM ERNEST (WILLIAM WELDON)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ERNEST
Last Name:WELDON
Suffix:
Gender:M
Credentials:WILLIAM WELDON
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:
Other - Last Name:WELDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WILLIAM WELDON
Mailing Address - Street 1:3178 MCCARROLL DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-928-2223
Mailing Address - Fax:
Practice Address - Street 1:3178 MCCARROLL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-928-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10865174400000X
LA010865208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist