Healthcare Provider Details

I. General information

NPI: 1407952336
Provider Name (Legal Business Name): KELSEY WEBB M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 OLD JEANERETTE RD
NEW IBERIA LA
70563-3040
US

IV. Provider business mailing address

2309 OLD JEANERETTE RD
NEW IBERIA LA
70563-3040
US

V. Phone/Fax

Practice location:
  • Phone: 337-256-5317
  • Fax: 337-256-8389
Mailing address:
  • Phone: 337-256-5317
  • Fax: 337-256-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number14980R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number14980R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: