Individual
DR. ANDRE ALBER BONNECAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025268
LA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
025268
LA
208M00000X
Hospitalist Physician
025268
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03120809
—
MS
05
—
1574864
—
LA
01
—
P00043115
RAIL ROAD MEDICARE
—
Enumeration date
08/02/2005
Last updated
02/04/2021
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