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General NPI Number Information
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NPI Number | 1588165617
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Entity Type | Organization
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Legal Business Name | SETH BILLIODEAUX MD LLC
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 02/23/2018
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Provider Practice Location Address
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Address Line | 4345 NELSON RD
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City | LAKE CHARLES
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State | LA
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Zip | 70605-4156
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Country | US
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Telephone | 337-480-7929
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Fax | 337-480-7904
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Provider Business Mailing Address
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Address Line | 3870 N JASMINE DR
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City | LAKE CHARLES
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State | LA
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Zip | 70605-3118
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | STAFF PHYSICIAN
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Name | DR. SETH BILLIODEAUX
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Credential | MD
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Telephone | 337-564-2829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD.202774
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License Number State | LA
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