Organization
ANDRE RAOUL BEZOU, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONELLE W COUCH (BUSINESS MANAGER)
(504) 887-5555
Entity
Organization
Contact information
Practice address
2727 LAKESHORE DR, MANDEVILLE, LA 70448-5629
(985) 892-8088
Mailing address
2727 LAKESHORE DR, MANDEVILLE, LA 70448-5629
(985) 892-8088
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
013197
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1161179
—
LA
Enumeration date
03/07/2007
Last updated
06/17/2008
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