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General NPI Number Information
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NPI Number | 1750500468
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Entity Type | Organization
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Legal Business Name | BAYOU FOOT CARE, LLC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 105 MEDICAL CENTER DR SUITE 302
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City | SLIDELL
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State | LA
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Zip | 70461-5544
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Country | US
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Telephone | 985-649-9795
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Fax | 985-649-9772
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Provider Business Mailing Address
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Address Line | PO BOX 54005
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City | NEW ORLEANS
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State | LA
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Zip | 70154-4005
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Country | US
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Telephone | 985-649-9795
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Fax | 985-649-9772
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Authorized Official
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Title or Position | OWNER
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Name | DR. DARREN MICHAEL VIGEE
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Credential | DPM
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Telephone | 985-649-9795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | LA
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