Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 001313 | GA |
N | 208600000X | Surgeon | 001313 | GA |
Y | 2086S0105X | Surgery of the Hand | 204868 | LA |
NPI | 1124205778 |
---|---|
Provider Name | Andrew Lee Foret |
First Address | Lake Charles, LA 70601-5724 |
Second Address | Lake Charles, LA 70605-5362 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2008 |
Last Update Date | 30/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2166174 | (05) | LA |