Provider Demographics
NPI:1265492714
Name:FORET, GERALD L JR (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:L
Last Name:FORET
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3311 PRESCOTT RD
Mailing Address - Street 2:SUITE 417
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3900
Mailing Address - Country:US
Mailing Address - Phone:318-704-6389
Mailing Address - Fax:318-704-6391
Practice Address - Street 1:433 PLAZA ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3729
Practice Address - Country:US
Practice Address - Phone:985-730-6700
Practice Address - Fax:985-730-6713
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2018-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.018213207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1377953Medicaid
LA1377953Medicaid
LA55134DC82Medicare PIN