Provider Demographics
NPI:1114910650
Name:PHILIPPE, KAY CHERRON (MD)
Entity Type:Individual
Prefix:
First Name:KAY CHERRON
Middle Name:
Last Name:PHILIPPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18367 PERKINS RD E
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-3917
Mailing Address - Country:US
Mailing Address - Phone:225-636-5437
Mailing Address - Fax:225-636-5547
Practice Address - Street 1:18367 PERKINS RD E
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-3917
Practice Address - Country:US
Practice Address - Phone:225-636-5437
Practice Address - Fax:225-636-5547
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022336208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1492612Medicaid
G51435Medicare UPIN
LA1492612Medicaid