Individual
MATTHEW PAUL GUILLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, FIRST FLOOR, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
5000 HENNESSY BLVD, FIRST FLOOR, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
204976
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
307031YJA2
MEDICARE
—
Enumeration date
03/19/2010
Last updated
10/17/2013
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