Individual
DR. BEATRICE S. DESPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 N CAUSEWAY BLVD, SUITE 1, MANDEVILLE, LA 70471-3209
(985) 674-4434
(985) 674-4374
Mailing address
1120 N CAUSEWAY BLVD, SUITE 1, MANDEVILLE, LA 70471-3209
(985) 674-9720
(985) 674-4374
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
15436R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1469742
—
LA
01
—
4K703CY96
MEDICARE INDIVIDUAL PTAN
LA
Enumeration date
02/10/2006
Last updated
05/21/2008
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