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Individual

GEORGE B COUSIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2309 E MAIN ST, STE 400, NEW IBERIA, LA 70560-4046
(337) 367-0271
(337) 364-6139
Mailing address
2309 E MAIN ST, STE 400, NEW IBERIA, LA 70560-4046
(337) 367-0271
(337) 364-6139

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
016174
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1339814
LA
Enumeration date
07/21/2005
Last updated
07/23/2012
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