| Paul Guilbault Md, Family Medicine, Llc | |
|
521 Asbury Drive Mandeville LA 70471 | |
| (985) 630-9618 | |
| (985) 231-7010 |
| Full Name | Paul Guilbault Md, Family Medicine, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 521 Asbury Drive, Mandeville, Louisiana |
| Authorized Official Name and Position | Robert Paul Guilbault (OWNER/PROPRIETOR) |
| Authorized Official Contact | 9856309618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Guilbault Md, Family Medicine, Llc 521 Asbury Drive Mandeville LA 70471 Ph: (985) 630-9618 | Paul Guilbault Md, Family Medicine, Llc 521 Asbury Drive Mandeville LA 70471 Ph: (985) 630-9618 |
| NPI Number | 1487185955 |
|---|---|
| Provider Enumeration Date | 03/25/2017 |
| Last Update Date | 03/21/2018 |
| Medicare PECOS PAC ID | 3173809449 |
|---|---|
| Medicare Enrollment ID | O20170421000873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487185955 | NPI | - | NPPES |
| 1541907 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 12621-R (Louisiana) | Primary |
| Provider Name | Robert P Guilbault |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275581092 PECOS PAC ID: 6608877279 Enrollment ID: I20070124000712 |
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