Gulf South Primary Care

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

025275 Issued in LA

Legal business name

GULF SOUTH PRIMARY CARE

Practice address

5145 Bluebonnet Blvd
Baton Rouge, LA 70809-3076

Phone

(225) 368-2480

NPI assigned

Jul 20, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen Guilbault

Title

Owner

Phone

(225) 892-2872

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279584000000",
    "number": "1093028060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5145 BLUEBONNET BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093076",
            "telephone_number": "225-368-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 BLUEBONNET BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093076",
            "telephone_number": "225-368-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF SOUTH PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-20",
        "last_updated": "2010-07-20",
        "status": "A",
        "authorized_official_last_name": "GUILBAULT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-892-2872"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "LA",
            "license": "025275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Teaching Family Services, Inc.
• Gulf Coast Teaching Family Services, Inc.
• Gulf Coast Teaching Family Services, Inc.
• Gulf South Animated Motion Technologies
• Gulf South BR - ABA, LLC
• Gulf State Interprise
• Gulf States Health Partners LLC
• Carley Gulino
• Staci S. Gulino, MSN, APRN-BC, PMHNP
• Thomas Ryan Gullatt, MD

• General Practice Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• General Practice Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.