Individual
DR. BENJAMIN THOMAS DEGATUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
206 CHAMPAGNE BLVD, SUITE A, BREAUX BRIDGE, LA 70517-3734
(337) 332-3500
(337) 332-3200
Mailing address
PO BOX 335, BREAUX BRIDGE, LA 70517-0335
(337) 654-4501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.205020
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2009
Last updated
06/28/2012
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