Healthcare Provider Details

I. General information

NPI: 1750500468
Provider Name (Legal Business Name): BAYOU FOOT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 MEDICAL CENTER DR SUITE 302
SLIDELL LA
70461-5544
US

IV. Provider business mailing address

PO BOX 54005
NEW ORLEANS LA
70154-4005
US

V. Phone/Fax

Practice location:
  • Phone: 985-649-9795
  • Fax: 985-649-9772
Mailing address:
  • Phone: 985-649-9795
  • Fax: 985-649-9772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateLA

VIII. Authorized Official

Name: DR. DARREN MICHAEL VIGEE
Title or Position: OWNER
Credential: DPM
Phone: 985-649-9795