Individual
DR. LACIE ARNOLD ALFONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-8987
(225) 765-8667
Mailing address
7850 ANSELMO LN, BATON ROUGE, LA 70810-1101
(257) 682-6419
(225) 765-8667
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
025460
LA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
025430
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06003510
—
MS
05
—
1574686
—
LA
Enumeration date
03/20/2006
Last updated
04/14/2025
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