Healthcare Provider Details

I. General information

NPI: 1720167869
Provider Name (Legal Business Name): GERARD FERNAND FALGOUST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 W LAKE DR
PORT ALLEN LA
70767-4272
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 225-776-0730
  • Fax: 225-256-2827
Mailing address:
  • Phone: 225-765-5727
  • Fax: 225-765-9196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number015656
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: