Healthcare Provider Details

I. General information

NPI: 1841461514
Provider Name (Legal Business Name): LONDON CADE GUIDRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 03/24/2022
Certification Date: 06/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8585 PICARDY AVE STE 310
BATON ROUGE LA
70809-3749
US

IV. Provider business mailing address

8585 PICARDY AVE STE 310
BATON ROUGE LA
70809-3749
US

V. Phone/Fax

Practice location:
  • Phone: 252-767-5479
  • Fax: 225-767-5147
Mailing address:
  • Phone: 225-767-5479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number200698
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number200698
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: