Provider Demographics
NPI:1356992119
Name:KEITH F. DESONIER, M.D, APMC
Entity type:Organization
Organization Name:KEITH F. DESONIER, M.D, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:DESONIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-439-0555
Mailing Address - Street 1:555 DR MICHAEL DEBAKEY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5700
Mailing Address - Country:US
Mailing Address - Phone:337-439-0555
Mailing Address - Fax:337-436-6223
Practice Address - Street 1:555 DR MICHAEL DEBAKEY DR STE 103
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5700
Practice Address - Country:US
Practice Address - Phone:337-439-0555
Practice Address - Fax:337-436-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty