Individual
DR. GEOFFREY A MIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
202 WESTGATE RD, LAFAYETTE, LA 70506
(337) 232-1802
(337) 232-1809
Mailing address
PO BOX 1948, SCOTT, LA 70583
(337) 232-1802
(337) 232-1809
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
025427
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1576140
—
LA
Enumeration date
07/07/2006
Last updated
10/09/2007
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