Provider Demographics
NPI:1144210618
Name:GAUDIN, LOUIS BEN II (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:BEN
Last Name:GAUDIN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7968 GOODWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7629
Mailing Address - Country:US
Mailing Address - Phone:225-923-3283
Mailing Address - Fax:225-923-3285
Practice Address - Street 1:7968 GOODWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7629
Practice Address - Country:US
Practice Address - Phone:225-923-3283
Practice Address - Fax:225-923-3285
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD019883207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LADG5454OtherRAILROAD MEDICARE
LA1651796Medicaid
LA5U914CY62Medicare PIN
LA1651796Medicaid