Provider Demographics
NPI:1104849579
Name:PATOUT, VENETIA MARIE NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:VENETIA
Middle Name:MARIE NICOLE
Last Name:PATOUT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:511 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-3819
Mailing Address - Country:US
Mailing Address - Phone:337-369-7722
Mailing Address - Fax:337-560-5554
Practice Address - Street 1:602 NORTH LEWIS STREET
Practice Address - Street 2:SUITE 600
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563
Practice Address - Country:US
Practice Address - Phone:337-560-1200
Practice Address - Fax:337-560-5554
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA023184207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1492485Medicaid
LAH25250Medicare UPIN
LA5H711Medicare PIN