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General NPI Number Information
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NPI Number | 1124338660
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Entity Type | Organization
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Legal Business Name | WAYNE P. DAIGLE, MD, LLC
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 155 HOSPITAL DR SUITE 400
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City | LAFAYETTE
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State | LA
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Zip | 70503-2852
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Country | US
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Telephone | 337-235-4460
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Fax | 337-235-3060
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Provider Business Mailing Address
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Address Line | 155 HOSPITAL DR SUITE 400
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City | LAFAYETTE
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State | LA
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Zip | 70503-2852
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Country | US
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Telephone | 337-235-4460
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Fax | 337-235-3060
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Authorized Official
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Title or Position | OWNER
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Name | DR. WAYNE PAUL DAIGLE
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Credential | MD
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Telephone | 337-235-4460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 015643
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License Number State | LA
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