Organization
GULF SOUTH PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN GUILBAULT (OWNER)
(225) 892-2872
Entity
Organization
Contact information
Practice address
5145 BLUEBONNET BLVD, BATON ROUGE, LA 70809-3076
(225) 368-2480
Mailing address
5145 BLUEBONNET BLVD, BATON ROUGE, LA 70809-3076
(225) 368-2480
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
025275
LA
Other
Enumeration date
07/20/2010
Last updated
07/20/2010
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