Individual
DR. EMMANUEL WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 W BOUNDARY AVE, WINNFIELD, LA 71483-3427
(318) 442-2859
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
07878R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1923231
—
LA
Enumeration date
05/21/2006
Last updated
08/05/2010
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