Individual
MATTHEW TYLER KHOSROPOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1110 E SAINT PETER ST, NEW IBERIA, LA 70560-3932
(337) 364-1166
(337) 364-7090
Mailing address
1012 PETROLEUM PKWY, BROUSSARD, LA 70518-8020
(337) 465-2159
(337) 465-4604
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09821
LA
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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