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General NPI Number Information
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NPI Number | 1962424705
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Entity Type | Individual
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Provider Name | TILDON KURT BELGARD MD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 03/04/2010
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Provider Practice Location Address
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Address Line | 8591 UNITED PLAZA BOULEVARD UNISYS LOUISIANA MEDICAID
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City | BATON ROUGE
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State | LA
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Zip | 70898
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Country | US
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Telephone | 800-877-0666
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14849
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City | BATON ROUGE
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State | LA
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Zip | 70898-4849
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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 |
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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 | 018914
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License Number State | LA
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