Organization
NEWELL E. GAUTHIER JR. MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NEWELL GAUTHIER JR. M.D. (OWNER)
(318) 941-2336
Entity
Organization
Contact information
Practice address
417 NORTH MLK DRIVE, SIMMESPORT, LA 71369
(318) 941-2336
(318) 941-2388
Mailing address
417 NORTH MLK DRIVE, SIMMESPORT, LA 71369
(318) 941-2336
(318) 941-2388
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
112
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448648
—
LA
Enumeration date
04/26/2007
Last updated
01/11/2008
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