Provider Demographics
NPI:1568422145
Name:CHAUVIN, KATHY L (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:L
Last Name:CHAUVIN
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 1:350 LAKEVIEW CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7514
Mailing Address - Country:US
Mailing Address - Phone:985-845-2677
Mailing Address - Fax:985-867-5498
Practice Address - Street 1:350 LAKEVIEW CT
Practice Address - Street 2:SUITE A
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7514
Practice Address - Country:US
Practice Address - Phone:985-845-2677
Practice Address - Fax:985-867-5498
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10802R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1490610Medicaid
LA1490610Medicaid
LA5A662Medicare PIN
LA5A662CN70Medicare PIN