Organization
NEWELL E. GAUTHIER, JR. MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEWELL E GAUTHIER JR. M.D. (OWNER)
(318) 876-3696
Entity
Organization
Contact information
Practice address
912 BRYAN ST., COTTONPORT, LA 71327
(318) 876-3696
(318) 876-3211
Mailing address
912 BRYAN ST., COTTONPORT, LA 71327
(318) 876-3696
(318) 876-3211
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
109
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448575
—
LA
Enumeration date
04/23/2007
Last updated
01/10/2008
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