Provider Demographics
NPI:1265528574
Name:COUGLE, ALLAN GARIGUE (MD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:GARIGUE
Last Name:COUGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:228-575-2120
Practice Address - Street 1:107 SMART PLACE
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2039
Practice Address - Country:US
Practice Address - Phone:985-847-9200
Practice Address - Fax:228-575-2120
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011862174400000X
MS11240174400000X
LAMD.0118622080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00115293Medicaid
LA1175382Medicaid
LA1175382Medicaid
LAB62487Medicare UPIN
MS370000169Medicare ID - Type UnspecifiedMISSISSIPPI MEDICARE
LA4P1427061Medicare PIN