Individual
COY W. GAMMAGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
411 CALYPSO ST STE 200A, MONROE, LA 71201-7551
(318) 966-1970
(318) 966-1971
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(318) 966-1970
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
021331
LA
207RH0003X
Hematology & Oncology Physician
Primary
021331
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1976652
—
LA
01
—
830005032
RRMC
LA
Enumeration date
07/07/2005
Last updated
10/13/2022
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