Provider Demographics
NPI:1366460966
Name:SONNIER, FREDERICK (PA)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:
Last Name:SONNIER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 RUE LOUIS XIV
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508
Mailing Address - Country:US
Mailing Address - Phone:337-235-8007
Mailing Address - Fax:337-235-8008
Practice Address - Street 1:108 RUE LOUIS XIV
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-235-8007
Practice Address - Fax:337-235-8008
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.A10416.RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1348066Medicaid
LA5CN33P869Medicare PIN
LA1348066Medicaid
LA5C822P734Medicare PIN
LA5CN33PG60Medicare PIN