Lynn M. Guidry, MD

Individual provider Active NPI General Practice Physician · Broussard, LA

NPI 1972584746 · NPPES record last updated Mar 29, 2018

Key facts

NPI
1972584746
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
015417 (LA)
Practice address
109 St. Nazaire Road
Broussard, LA 70518
Phone
(337) 470-7580
Fax
(337) 839-0110
NPI assigned
Nov 9, 2005
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
015417LAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn M. Guidry MD Past
since Jan 1, 1990
Accepting new patients
L & L Medical & Diagnostic Center, LLC Past
since Dec 1, 2006
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 015417 LA Yes

Addresses

Primary practice location

109 St. Nazaire Road
Broussard, LA 70518

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0010

Other practice location 1

705 S Morgan Ave
Broussard, LA 70518-4951
Phone (337) 896-0424

Other providers in Broussard, LA

All providers in Broussard, LA · General Practice Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.