Healthcare Provider Details

I. General information

NPI: 1821067414
Provider Name (Legal Business Name): STEVE V BUTAUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 S COLLEGE RD SUITE 307
LAFAYETTE LA
70503-3038
US

IV. Provider business mailing address

PO BOX 52068
LAFAYETTE LA
70505-2068
US

V. Phone/Fax

Practice location:
  • Phone: 337-237-5225
  • Fax: 337-237-5405
Mailing address:
  • Phone: 337-233-7174
  • Fax: 337-269-0981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number016913
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: