Basic Information
Provider Information
NPI: 1104288570
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARCEL
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7373 PERKINS RD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708084373
CountryCode: US
TelephoneNumber: 2252469790
FaxNumber: 2252469100
Practice Location
Address1: 7373 PERKINS RD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708084373
CountryCode: US
TelephoneNumber: 2257694044
FaxNumber: 2252469116
Other Information
ProviderEnumerationDate: 03/24/2016
LastUpdateDate: 10/29/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X311859LAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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