Individual
DR. WILLIAM L OVERDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 LINE AVENUE, SUITE 100, SHREVEPORT, LA 71101
(318) 635-3052
(318) 635-3072
Mailing address
1500 LINE AVENUE, SUITE 100, SHREVEPORT, LA 71101
(318) 635-3052
(318) 635-3072
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
014596
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053315846
GROUP NPI NUMBER
LA
05
—
1329673
—
LA
01
—
200016529
RAILROAD MEDICARE
LA
Enumeration date
06/09/2005
Last updated
09/10/2009
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