Provider Demographics
NPI:1922049857
Name:GOLAN, YASEMIN (MD)
Entity Type:Individual
Prefix:
First Name:YASEMIN
Middle Name:
Last Name:GOLAN
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 1:1014 TOM DRIVE
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-2709
Mailing Address - Country:US
Mailing Address - Phone:337-363-3061
Mailing Address - Fax:337-363-3063
Practice Address - Street 1:1014 TOM DRIVE
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-2709
Practice Address - Country:US
Practice Address - Phone:337-363-3061
Practice Address - Fax:337-363-3063
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12533R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA7163213OtherAETNA
LA1105848Medicaid
4A147Medicare ID - Type Unspecified
LA7163213OtherAETNA