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General NPI Number Information
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NPI Number | 1356761977
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Entity Type | Individual
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Provider Name | STEPHANIE COLLIER GUIDRY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 125 HOWELL RD
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City | WINNFIELD
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State | LA
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Zip | 71483-7263
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Country | US
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Telephone | 504-236-3063
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Fax |
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Provider Business Mailing Address
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Address Line | 501 ORIOLE ST
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City | METAIRIE
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State | LA
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Zip | 70003-4237
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Country | US
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Telephone | 504-236-3063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | PGY.202360
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 307538
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License Number State | LA
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