Provider Demographics
NPI:1922322940
Name:ORGERON, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:ORGERON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2104 GAUSE BLVD W
Mailing Address - Street 2:STE A
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-4130
Mailing Address - Country:US
Mailing Address - Phone:985-643-4575
Mailing Address - Fax:985-643-4513
Practice Address - Street 1:2104 GAUSE BLVD W
Practice Address - Street 2:STE. A
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70460-4130
Practice Address - Country:US
Practice Address - Phone:985-643-4575
Practice Address - Fax:985-643-4513
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2021-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS23241208D00000X
AL32590208D00000X
FL8987208D00000X
LA205704208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty