Healthcare Provider Details

I. General information

NPI: 1376033118
Provider Name (Legal Business Name): ALEXIS VICTORIA GUICE ALBIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 FORSYTHE AVE
MONROE LA
71201-3014
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 318-966-5450
  • Fax: 318-966-5451
Mailing address:
  • Phone: 318-966-5450
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number330854
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number330854
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: