Provider Demographics
NPI:1720167869
Name:FALGOUST, GERARD FERNAND (MD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:FERNAND
Last Name:FALGOUST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-765-5727
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:766 W LAKE DR
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-4272
Practice Address - Country:US
Practice Address - Phone:225-776-0730
Practice Address - Fax:225-256-2827
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015656207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1332399Medicaid
LA51819YJA2Medicare PIN
LA1332399Medicaid
LA51819Medicare ID - Type Unspecified