NPI 1093028060

Gulf South Primary Care

Organisation General Practice Physician Baton Rouge, LA

Practice location

Address: 5145 Bluebonnet Blvd, Baton Rouge, LA 70809-3076
Phone: (225) 368-2480

Authorised official

Name: Stephen Guilbault
Title: Owner
Phone: (225) 892-2872

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 025275 (LA)

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Registry record

NPI: 1093028060
Entity type: Organization
NPI issued: 20 Jul 2010
Record last updated: 20 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.