Organization
PAUL GUILBAULT MD, FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT PAUL GUILBAULT III M.D. (OWNER/PROPRIETOR)
(985) 630-9618
Entity
Organization
Contact information
Practice address
521 ASBURY DRIVE, MANDEVILLE, LA 70471
(985) 630-9618
(985) 231-7010
Mailing address
521 ASBURY DRIVE, MANDEVILLE, LA 70471
(985) 630-9618
(985) 231-7010
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
12621-R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1541907
—
LA
Enumeration date
03/25/2017
Last updated
03/21/2018
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