Provider Demographics
NPI:1134216518
Name:GAUTHIER, ARIADNE A (MD)
Entity type:Individual
Prefix:
First Name:ARIADNE
Middle Name:A
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARIADNE
Other - Middle Name:LIZETTE
Other - Last Name:ALMADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3149 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-7209
Mailing Address - Country:US
Mailing Address - Phone:337-706-3415
Mailing Address - Fax:
Practice Address - Street 1:3149 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7209
Practice Address - Country:US
Practice Address - Phone:337-706-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.199921208M00000X
LA199921207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1447382Medicaid
LA1376542506OtherBUSINESS NPI
LA1376542506OtherBUSINESS NPI
LA1447382Medicaid
LA1447382Medicaid