Individual
DR. DANIEL JOSEPH BOURGEOIS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 ROBERT BLVD STE 100, SLIDELL, LA 70458-2068
(985) 280-8868
(985) 280-6642
Mailing address
1120 ROBERT BLVD STE 100, SLIDELL, LA 70458-2068
(985) 280-8688
(985) 280-6642
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD.304471
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2437461
—
LA
Enumeration date
08/27/2012
Last updated
12/27/2021
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