| Lori Gautreaux Bergeron Llc | |
|
4640 W Congress St Lafayette LA 70506-6622 | |
| (337) 678-4401 | |
| (866) 393-8293 |
| Full Name | Lori Gautreaux Bergeron Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4640 W Congress St, Lafayette, Louisiana |
| Authorized Official Name and Position | Lori N Gautreaux (MD/OWNER) |
| Authorized Official Contact | 3376784401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lori Gautreaux Bergeron Llc 4640 W Congress St Lafayette LA 70506-6622 Ph: (337) 678-4401 | Lori Gautreaux Bergeron Llc 4640 W Congress St Lafayette LA 70506-6622 Ph: (337) 678-4401 |
| NPI Number | 1912369851 |
|---|---|
| Provider Enumeration Date | 03/21/2016 |
| Last Update Date | 06/24/2024 |
| Medicare PECOS PAC ID | 4284921461 |
|---|---|
| Medicare Enrollment ID | O20161003002011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912369851 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lori N Gautreaux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942576855 PECOS PAC ID: 4981909660 Enrollment ID: I20161003002218 |
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