Individual
DUSTIN RAND GOUDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
3351 MASONIC DR, ALEXANDRIA, LA 71301-3842
(318) 473-9556
(318) 441-8339
Mailing address
3351 MASONIC DR, ALEXANDRIA, LA 71301-3842
(318) 473-9556
(318) 441-8339
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAA10612
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00246919
RAILROAD MEDICARE PALMETT
LA
Enumeration date
02/16/2006
Last updated
12/10/2009
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