Individual
WILLIAM JACKSON DEFEE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5507 SHREVEPORT HWY, PINEVILLE, LA 71360-3533
(318) 640-7847
(318) 640-7108
Mailing address
PO BOX 1390, TIOGA, LA 71477-1390
(318) 640-7847
(318) 640-7108
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
011645
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1118907
—
LA
Enumeration date
06/29/2006
Last updated
07/08/2007
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