Individual
DR. WAYNE JOSEPH PHARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 N ACADIA RD, THIBODAUX, LA 70301-4856
(985) 448-0649
(985) 448-0785
Mailing address
400 N ACADIA RD, THIBODAUX, LA 70301-4856
(985) 448-0649
(985) 448-0785
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
016262
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358614
—
LA
Enumeration date
05/31/2006
Last updated
04/06/2010
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