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General NPI Number Information
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NPI Number | 1194095109
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Entity Type | Organization
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Legal Business Name | GERARD F. SIGUE MD, MS, LLC
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 2308 E MAIN ST SUITE E
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City | NEW IBERIA
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State | LA
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Zip | 70560-4041
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Country | US
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Telephone | 337-608-9043
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Fax |
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Provider Business Mailing Address
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Address Line | 217 GLENEAGLES CIR
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City | BROUSSARD
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State | LA
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Zip | 70518-6185
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Country | US
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Telephone | 337-331-5672
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | CANDICE SIGUE
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Credential |
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Telephone | 337-331-5672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 022140
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License Number State | LA
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