Provider Demographics
NPI:1447475652
Name:FOREMAN, JULIE LARKIN (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LARKIN
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:ELIZABETH
Other - Last Name:LARKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:203 RUE LOUIS XIV STE A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5736
Mailing Address - Country:US
Mailing Address - Phone:337-981-2393
Mailing Address - Fax:337-981-9470
Practice Address - Street 1:203 RUE LOUIS XIV STE A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5736
Practice Address - Country:US
Practice Address - Phone:337-981-2393
Practice Address - Fax:337-981-9470
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA204569207W00000X
LAMD.204569207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2150855Medicaid
LA4Q325Medicare PIN