Provider Demographics
NPI:1558371450
Name:NOEL, JACQUE F III (MD)
Entity Type:Individual
Prefix:MR
First Name:JACQUE
Middle Name:F
Last Name:NOEL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1211 COOLIDGE BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2638
Mailing Address - Country:US
Mailing Address - Phone:337-235-9779
Mailing Address - Fax:337-235-0654
Practice Address - Street 1:1211 COOLIDGE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2638
Practice Address - Country:US
Practice Address - Phone:337-235-9779
Practice Address - Fax:337-235-0654
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2011-08-01
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Provider Licenses
StateLicense IDTaxonomies
LA017730207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1386642Medicaid
LAE02958Medicare UPIN
LA55691Medicare PIN