# WARREN J. DEGATUR, JR. MD INC

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

## Provider details

- **NPI number:** 1568654689
- **Authorized official:** RAMONA FOSTER (MEDICAL RECORDS)
- **Authorized official phone:** (337) 332-3500

## Contact information

- **Practice address:** 206 CHAMPAGNE BLVD, SUITE A, BREAUX BRIDGE, LA 70517-3700
- **Practice address phone:** (337) 332-3500
- **Mailing address:** 206 CHAMPAGNE BLVD, SUITE A, BREAUX BRIDGE, LA 70517-3700
- **Mailing address phone:** (337) 332-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 017128 | LA | Yes |

## Other

- **Enumeration date:** 08/13/2007
- **Last updated:** 01/20/2010