Healthcare Provider Details

I. General information

NPI: 1356301741
Provider Name (Legal Business Name): GERALD A LOUVIERE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WALTERS ST
LAKE CHARLES LA
70607-4647
US

IV. Provider business mailing address

1800 RYAN ST SUITE 105
LAKE CHARLES LA
70601-6078
US

V. Phone/Fax

Practice location:
  • Phone: 337-475-8100
  • Fax: 337-475-8416
Mailing address:
  • Phone: 337-439-4706
  • Fax: 337-439-8110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number013247
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: