Individual
DR. MARYKUTTY J THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7949 JEFFERSON HWY, BATON ROUGE, LA 70809-1385
(225) 709-7584
Mailing address
9241 BLUEBONNET BLVD, SUITE B, BATON ROUGE, LA 70810-2808
(225) 757-6031
(225) 757-6035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
022386
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1676471
—
LA
Enumeration date
07/15/2005
Last updated
08/06/2024
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