Healthcare Provider Details

I. General information

NPI: 1700888005
Provider Name (Legal Business Name): ANDREE BODET CAILLET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 KALISTE SALOOM RD
LAFAYETTE LA
70508-7422
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 337-470-2636
  • Fax: 337-981-6811
Mailing address:
  • Phone: 225-526-0001
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number023035
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: