Individual
DR. WARREN J. DEGATUR JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
206 CHAMPAGNE BLVD, SUITE A, BREAUX BRIDGE, LA 70517-3700
(337) 332-3500
Mailing address
PO BOX 335, BREAUX BRIDGE, LA 70517-0335
(337) 332-3500
(337) 332-3200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
017128
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1344940
—
LA
Enumeration date
03/23/2006
Last updated
08/20/2007
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