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General NPI Number Information
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NPI Number | 1154599983
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Entity Type | Organization
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Legal Business Name | PAUL H. GULOTTA, JR., M.D., A.P.M.C.
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 2313 E MAIN ST SUITE C
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City | NEW IBERIA
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State | LA
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Zip | 70560-4091
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Country | US
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Telephone | 337-364-1734
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Fax | 337-364-4717
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Provider Business Mailing Address
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Address Line | 2313 E MAIN ST SUITE C
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City | NEW IBERIA
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State | LA
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Zip | 70560-4091
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Country | US
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Telephone | 337-364-1734
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Fax | 337-364-4717
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL HENRY GULOTTA JR.
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Credential | M.D.
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Telephone | 337-364-1734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 017276
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License Number State | LA
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