# GULF SOUTH PRIMARY CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093028060
- **Authorized official:** STEPHEN GUILBAULT (OWNER)
- **Authorized official phone:** (225) 892-2872

## Contact information

- **Practice address:** 5145 BLUEBONNET BLVD, BATON ROUGE, LA 70809-3076
- **Practice address phone:** (225) 368-2480
- **Mailing address:** 5145 BLUEBONNET BLVD, BATON ROUGE, LA 70809-3076
- **Mailing address phone:** (225) 368-2480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 025275 | LA | Yes |

## Other

- **Enumeration date:** 07/20/2010
- **Last updated:** 07/20/2010