Individual
MARY MARELLE YONGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
UNIVERSITY OF LOUISIANA LAFAYETTE STUDENT HEALTH SERV, 120 BOUCHER DR., LAFAYETTE, LA 70504-0001
(337) 482-6826
(337) 482-6428
Mailing address
335 W BRIDGE ST, BREAUX BRIDGE, LA 70517-5040
(337) 332-5505
(337) 482-6826
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
13862
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301892
—
LA
Enumeration date
07/04/2006
Last updated
07/08/2007
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