Individual
MATTHEW STEPHEN LATIOLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
12525 PERKINS RD, BATON ROUGE, LA 70810-1907
(225) 819-8857
(225) 767-6822
Mailing address
7777 HENNESSY BLVD, SUITE 1004-154, BATON ROUGE, LA 70808-4300
(225) 214-9352
(225) 214-9349
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200141
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027839
—
LA
Enumeration date
12/27/2007
Last updated
03/20/2012
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