Healthcare Provider Details

I. General information

NPI: 1992124382
Provider Name (Legal Business Name): LAUREN DENISE BARTHOLOMEW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1057 PAUL MAILLARD RD
LULING LA
70070-4349
US

IV. Provider business mailing address

1936 MAGAZINE ST
NEW ORLEANS LA
70130-5016
US

V. Phone/Fax

Practice location:
  • Phone: 985-764-6036
  • Fax:
Mailing address:
  • Phone: 504-529-5558
  • Fax: 504-529-8840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number308401
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: