Basic Information
| Provider Information | |||||||||
| NPI: | 1548308935 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LOUISE GAUTREAUX COLLINS MD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 231 W ESPLANADE AVE | ||||||||
| Address2: | STE B | ||||||||
| City: | KENNER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700652459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044647729 | ||||||||
| FaxNumber: | 5044646343 | ||||||||
| Practice Location | |||||||||
| Address1: | 231 W ESPLANADE AVE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | KENNER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700652459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044647729 | ||||||||
| FaxNumber: | 5044646343 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | COLLINS | ||||||||
| AuthorizedOfficialFirstName: | LOUISE | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5044647729 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 10500R | LA | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.