Healthcare Provider Details

I. General information

NPI: 1467550830
Provider Name (Legal Business Name): CHARON EMILY GENTILE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 GABASSE ST
HOUMA LA
70360-4417
US

IV. Provider business mailing address

259 GABASSE ST
HOUMA LA
70360-4417
US

V. Phone/Fax

Practice location:
  • Phone: 985-873-7244
  • Fax: 985-876-2111
Mailing address:
  • Phone: 985-873-7244
  • Fax: 985-876-2111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD.12368R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: