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General NPI Number Information
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NPI Number | 1831458991
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Entity Type | Organization
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Legal Business Name | LAGNIAPPE FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 10/30/2013
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Provider Practice Location Address
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Address Line | 8342 PERKINS RD SUITE M
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City | BATON ROUGE
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State | LA
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Zip | 70810-1020
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Country | US
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Telephone | 225-218-4044
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Fax | 225-308-4309
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Provider Business Mailing Address
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Address Line | 8342 PERKINS RD SUITE M
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City | BATON ROUGE
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State | LA
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Zip | 70810-1020
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Country | US
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Telephone | 225-218-4044
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Fax | 225-308-4309
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Authorized Official
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Title or Position | OWNER
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Name | DR. LARRY LEE MONTGOMERY
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Credential | M.D.
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Telephone | 225-218-4044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.202410
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License Number State | LA
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