MEDICARE: DR. ROLAND J. DEGEYTER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	013214	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110003303	OTHER	LA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386631109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROLAND J. DEGEYTER MD

Provider Business Mailing Address
First Line	:	502 HAIFLEIGH ST
Second Line	:
City	:	FRANKLIN
State	:	LA
Zip	:	70538-3854
Country	:	US
Telephone Number	:	337-261-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 HAIFLEIGH ST
Second Line	:
City	:	FRANKLIN
State	:	LA
Zip	:	70538-3854
Country	:	US
Telephone Number	:	337-261-5151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	11/08/2010

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