Organization
IBERIA DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENETIA MARIE NICOLE PATOUT M.D. (OWNER)
(337) 560-1200
Entity
Organization
Contact information
Practice address
602 N LEWIS ST, SUITE 600, NEW IBERIA, LA 70563-2093
(337) 560-1200
(337) 560-5554
Mailing address
PO BOX 10938, NEW IBERIA, LA 70562-0938
(337) 560-1200
(337) 560-5554
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
023184
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1492485
—
LA
Enumeration date
02/28/2007
Last updated
10/01/2007
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