Provider Demographics
NPI:1669440780
Name:MONIER, PAUL L (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:MONIER
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 1:764 N ACADIA RD
Mailing Address - Street 2:STE A
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-5009
Mailing Address - Country:US
Mailing Address - Phone:985-446-1958
Mailing Address - Fax:985-446-0121
Practice Address - Street 1:764 N ACADIA RD
Practice Address - Street 2:STE A
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-5009
Practice Address - Country:US
Practice Address - Phone:985-446-1958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14074R207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1189987Medicaid
LA4A563Medicare ID - Type Unspecified
LAG79061Medicare UPIN