Indira Gautam MD a Professional Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15134R Issued in LA

Legal business name

INDIRA GAUTAM MD A PROFESSIONAL MEDICAL CORPORATION

Practice address

327 Iberia St
Suite 3a
Youngsville, LA 70592-6370

Phone

(337) 857-3512

NPI assigned

Sep 24, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Indira Gautam, MD

Title

Owner

Phone

(337) 857-3512

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1235531989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 IBERIA ST",
            "address_2": "SUITE 3A",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705926370",
            "telephone_number": "337-857-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 IBERIA ST",
            "address_2": "SUITE 3A",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705926370",
            "telephone_number": "337-857-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIRA GAUTAM MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "GAUTAM",
        "authorized_official_first_name": "INDIRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-857-3512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "15134R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1191167",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathalie Alta Hutchinson
• Tabitha D Hyppolite
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• In-Home Therapy LLC
• Shea Inman, MD
• Integrative Medicine of Acadiana LLC
• Interim Benefits Consultants, LTD
• Emily Laszczak Inzerella, PT, DPT
• Leila Alexandra Irvan, RDN

• Family Medicine Physician in Youngsville, LA
• Providers in Youngsville, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.