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General NPI Number Information
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NPI Number | 1619946001
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Entity Type | Individual
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Provider Name | LIONEL GUILLAUME M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 3018 OLD MINDEN RD SUITE 1212
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City | BOSSIER CITY
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State | LA
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Zip | 71112-2495
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Country | US
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Telephone | 318-747-1665
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Fax | 318-747-1597
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Provider Business Mailing Address
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Address Line | 3018 OLD MINDEN RD SUITE 1212
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City | BOSSIER CITY
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State | LA
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Zip | 71112-2476
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Country | US
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Telephone | 318-747-1665
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Fax | 318-747-1597
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 017032
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 017032
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License Number State | LA
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