Provider Demographics
NPI:1871981639
Name:ANDRE G. GUETTE, M.D., LLC
Entity type:Organization
Organization Name:ANDRE G. GUETTE, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CODER AND BILLING
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIMES
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:504-457-0001
Mailing Address - Street 1:4740 S I 10 SERVICE RD W
Mailing Address - Street 2:SUITE 340
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1234
Mailing Address - Country:US
Mailing Address - Phone:504-457-0001
Mailing Address - Fax:504-455-0001
Practice Address - Street 1:4740 S I 10 SERVICE RD W
Practice Address - Street 2:SUITE 340
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1234
Practice Address - Country:US
Practice Address - Phone:504-457-0001
Practice Address - Fax:504-455-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA012305207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1300161Medicaid
LAB64135Medicare UPIN