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General NPI Number Information
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NPI Number | 1386728541
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Entity Type | Individual
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Provider Name | JOHN T ALLGOOD JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 4049 I-49 SOUTH SERVICE RD
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City | OPELOUSAS
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State | LA
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Zip | 70570
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Country | US
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Telephone | 337-942-2674
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Fax | 337-948-1858
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Provider Business Mailing Address
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Address Line | 4049 I-49 SOUTH SERVICE ROAD
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City | OPELOUSAS
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State | LA
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Zip | 70570
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Country | US
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Telephone | 337-942-2674
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Fax | 337-948-1858
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA..A10008.RX
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License Number State | LA
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