Provider Demographics
NPI:1013386440
Name:FALGOUT, LUKE JOSEPH
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:JOSEPH
Last Name:FALGOUT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:LA
Mailing Address - Zip Code:70374-2151
Mailing Address - Country:US
Mailing Address - Phone:985-805-0829
Mailing Address - Fax:
Practice Address - Street 1:906 E 1ST ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6701
Practice Address - Country:US
Practice Address - Phone:877-642-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program