Provider Demographics
NPI:1356371231
Name:GOSSERAND, JOHN L (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:GOSSERAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3311 PRESCOTT RD STE 411
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3985
Mailing Address - Country:US
Mailing Address - Phone:318-448-5310
Mailing Address - Fax:318-448-7110
Practice Address - Street 1:3311 PRESCOTT RD
Practice Address - Street 2:SUITE 411
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3900
Practice Address - Country:US
Practice Address - Phone:318-448-5310
Practice Address - Fax:318-448-7110
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2014-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.01896207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1059579Medicaid
LA167984Medicare UPIN
LA4K3647061Medicare PIN