Individual
COLLINS T KGOADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2810 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5906
(337) 981-2949
Mailing address
121 CRESTHILL DR, YOUNGSVILLE, LA 70592-5656
(337) 356-8834
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
305550
LA
Other
Enumeration date
08/02/2017
Last updated
08/02/2017
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