Organization
WARREN J. DEGATUR, JR. MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMONA FOSTER (MEDICAL RECORDS)
(337) 332-3500
Entity
Organization
Contact information
Practice address
206 CHAMPAGNE BLVD, SUITE A, BREAUX BRIDGE, LA 70517-3700
(337) 332-3500
Mailing address
206 CHAMPAGNE BLVD, SUITE A, BREAUX BRIDGE, LA 70517-3700
(337) 332-3500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
017128
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720047079
NPI-INDVIDUAL
—
05
—
1949329
—
LA
Enumeration date
08/13/2007
Last updated
01/20/2010
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