Individual
DR. LORETTA PYLANT GREMILLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2409 BROADMOOR BLVD, MONROE, LA 71201-2964
(318) 323-8799
(318) 323-8815
Mailing address
1868 FORSYTHE AVE, STE 335, MONROE, LA 71201-3540
(318) 251-6216
(318) 251-6257
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
026501
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1059587
—
LA
01
—
4N1007387
MEDICARE
LA
Enumeration date
08/05/2007
Last updated
06/08/2018
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