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General NPI Number Information
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NPI Number | 1629176615
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Entity Type | Individual
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Provider Name | GARETT G GUILBEAU PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 3704 NORTH BLVD SUITE C
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3658
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Country | US
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Telephone | 318-443-4576
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Fax | 318-449-5579
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Provider Business Mailing Address
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Address Line | 3704 NORTH BLVD SUITE C
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3658
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Country | US
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Telephone | 318-443-4576
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Fax | 318-449-5579
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1069238
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 200564
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License Number State | LA
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