Individual
DR. ALFRED MATHEW FOGARTY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
823 W CALIFORNIA AVE, RUSTON, LA 71270-4981
(318) 251-9458
(318) 251-9904
Mailing address
3109 ENGLISH TURN, RUSTON, LA 71270-2670
(318) 548-0315
(318) 251-9904
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD021829
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022800
CDS
LA
05
—
1661759
—
LA
01
—
MD021829
MEDICAL LICENSE NUMBER
LA
Enumeration date
09/02/2006
Last updated
03/07/2023
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