Healthcare Provider Details

I. General information

NPI: 1518378538
Provider Name (Legal Business Name): AIMEE REBECCA CAILLET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 CONSTANTIN BLVD FL 4
BATON ROUGE LA
70809-3481
US

IV. Provider business mailing address

8200 CONSTANTIN BLVD FL 4
BATON ROUGE LA
70809-3481
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-5500
  • Fax: 225-765-2054
Mailing address:
  • Phone: 225-765-5500
  • Fax: 225-765-2054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number55877
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT-2772
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number321850
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: