# JEANNE D. THERIOT MD APMLLC

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

## Provider details

- **NPI number:** 1174581342
- **Authorized official:** JEANNE DAUPHINE THERIOT M.D. (OWNER/DIRECTOR)
- **Authorized official phone:** (337) 332-2242

## Contact information

- **Practice address:** 112 CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3852
- **Practice address phone:** (337) 332-2242
- **Mailing address:** 112 CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3852
- **Mailing address phone:** (337) 332-2242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | LA | Yes |

## Other

- **Enumeration date:** 05/03/2006
- **Last updated:** 03/10/2008