Provider Demographics
NPI:1720167869
Name:FALGOUST, GERARD FERNAND (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:FERNAND
Last Name:FALGOUST
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 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-765-5727
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:59315 RIVER WEST DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764
Practice Address - Country:US
Practice Address - Phone:225-687-6629
Practice Address - Fax:225-687-6669
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015656207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1332399Medicaid
LA51819YJA2Medicare PIN
LA1332399Medicaid
LA51819Medicare ID - Type Unspecified