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Individual

GARTH THESIEGER KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
701 CYPRESS ST, SULPHUR, LA 70663-5053
(800) 893-9698
Mailing address
200 CORPORATE BLVD, STE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
200225
LA
207R00000X
Internal Medicine Physician
Primary
200225
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1058394
LA
Enumeration date
08/08/2006
Last updated
03/22/2013
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