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Individual

DR. THOMAS G. LATIOLAIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1025 HIGHWAY 80, HAUGHTON, LA 71037-7425
(318) 949-0539
(318) 949-0759
Mailing address
1908 LANDAU LN, BOSSIER CITY, LA 71111-5527
(318) 426-0206

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
208000000X
Pediatrics Physician
Primary
016345
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1338583
LA
Enumeration date
06/20/2005
Last updated
06/23/2019
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