Healthcare Provider Details

I. General information

NPI: 1699352690
Provider Name (Legal Business Name): PAIGE ELIZABETH GUILLORY MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. PAIGE GUILLORY PETTUS

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 RUE DE LA VIE ST STE 510
BATON ROUGE LA
70817-5129
US

IV. Provider business mailing address

500 RUE DE LA VIE ST STE 510
BATON ROUGE LA
70817-5129
US

V. Phone/Fax

Practice location:
  • Phone: 225-928-5951
  • Fax: 225-928-5535
Mailing address:
  • Phone: 225-928-5951
  • Fax: 225-928-5535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number345934
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number45358
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: