Basic Information
| Provider Information | |||||||||
| NPI: | 1134562523 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PROUET | ||||||||
| FirstName: | PHILIPPE | ||||||||
| MiddleName: | EDOUARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 324 DULLES DR | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705063008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3377061582 | ||||||||
| FaxNumber: | 3372612697 | ||||||||
| Practice Location | |||||||||
| Address1: | 1211 COOLIDGE BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705032638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372898400 | ||||||||
| FaxNumber: | 3372898401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2013 | ||||||||
| LastUpdateDate: | 07/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RH0003X | 312641 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.