Healthcare Provider Details

I. General information

NPI: 1447307392
Provider Name (Legal Business Name): STEPHANIE CAUBLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 PERKINS RD
BATON ROUGE LA
70808-4326
US

IV. Provider business mailing address

7373 PERKINS RD
BATON ROUGE LA
70808-4326
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-4044
  • Fax:
Mailing address:
  • Phone: 225-769-4044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.202257
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD.202257
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: