Provider Demographics
NPI:1619080876
Name:SOIGNET, JOHN DAMIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAMIAN
Last Name:SOIGNET
Suffix:
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 1:1750 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2465
Mailing Address - Country:US
Mailing Address - Phone:958-851-0188
Mailing Address - Fax:
Practice Address - Street 1:1750 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2465
Practice Address - Country:US
Practice Address - Phone:958-851-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.10725R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1685844Medicaid
LA1685844Medicaid
LAG29723Medicare UPIN