Provider Demographics
NPI:1023231826
Name:MCCOWN, WILLIAM (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:MCCOWN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 STOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-1663
Mailing Address - Country:US
Mailing Address - Phone:318-342-1349
Mailing Address - Fax:
Practice Address - Street 1:294 CHARLES ESTES ROAD
Practice Address - Street 2:
Practice Address - City:EROS
Practice Address - State:LA
Practice Address - Zip Code:71238
Practice Address - Country:US
Practice Address - Phone:318-513-1461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA809103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical