Provider Demographics
NPI:1033636345
Name:EMILY B VIGOUR, MD LLC
Entity Type:Organization
Organization Name:EMILY B VIGOUR, MD LLC
Other - Org Name:VIGOUR PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:B
Authorized Official - Last Name:VIGOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-325-5437
Mailing Address - Street 1:3712 MACARTHUR BLVD STE 100-A
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6802
Mailing Address - Country:US
Mailing Address - Phone:504-325-5437
Mailing Address - Fax:504-556-2806
Practice Address - Street 1:3712 MACARTHUR BLVD STE 100-A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6802
Practice Address - Country:US
Practice Address - Phone:504-325-5437
Practice Address - Fax:504-556-2806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1062855Medicaid