Individual
STANLEY J GUILLOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3330 MASONIC DR, ALEXANDRIA, LA 71301-3841
(318) 448-6700
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-0996
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200156
LA
363AM0700X
Medical Physician Assistant
PA200156
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036056
—
LA
01
—
PA200156
LICENSE
LA
Enumeration date
11/13/2007
Last updated
01/16/2017
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