Provider Demographics
NPI:1184924839
Name:CHAD GAUTREAUX
Entity type:Organization
Organization Name:CHAD GAUTREAUX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GAUTREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-855-0483
Mailing Address - Street 1:9020 WORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2722
Mailing Address - Country:US
Mailing Address - Phone:985-855-0483
Mailing Address - Fax:
Practice Address - Street 1:9020 WORTH AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2722
Practice Address - Country:US
Practice Address - Phone:985-855-0483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty