Individual
DR. RANDAL LEE PILGRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1105 KALISTE SALOOM RD, LAFAYETTE, LA 70508-5705
(800) 893-9698
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
13341R
LA
207Q00000X
Family Medicine Physician
13341R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1562416
—
LA
Enumeration date
04/07/2006
Last updated
12/06/2012
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