Paul Guilbault MD, Family Medicine, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

12621-R Issued in LA

Legal business name

PAUL GUILBAULT MD, FAMILY MEDICINE, LLC

Practice address

521 Asbury Drive
Mandeville, LA 70471

Phone

(985) 630-9618

Fax

(985) 231-7010

NPI assigned

Mar 25, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Robert Paul Guilbault III, M.D.NPI 1275581092

Title

Owner/Proprietor

Phone

(985) 630-9618

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert P Guilbault III, MD

  • Family Medicine Physician
  • Mandeville, LA
  • NPI 1275581092
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521590400000",
    "number": "1487185955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 ASBURY DRIVE",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "70471",
            "telephone_number": "985-630-9618",
            "fax_number": "985-231-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ASBURY DRIVE",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "70471",
            "telephone_number": "985-630-9618",
            "fax_number": "985-231-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL GUILBAULT MD, FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-25",
        "last_updated": "2018-03-21",
        "status": "A",
        "authorized_official_last_name": "GUILBAULT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/PROPRIETOR",
        "authorized_official_telephone_number": "985-630-9618",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "12621-R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1541907",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kay Parker, SLP
• Jennifer Lynn Parkerson, MD
• Passages, LLC
• Louis Charles Passauer Jr., D.D.S.
• Jo Ann Patton, LPN
• Paul Van Deventer, M.D., Apmc
• Kathleen M. Paul, LCSW
• Geraldine Stewart Payne, M.D.
• Rebecca Payne, DDS, MS
• Virginia Catherine Jensen Peden, LMFT

• Primary Care Clinic/Center in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.