Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD.008946 | LA |
NPI | 1285070995 |
---|---|
Provider Name | Dr. Gerald Lee Foret |
First Address | Franklinton, LA 70438-5129 |
Second Address | Franklinton, LA 70438-5129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2013 |
Last Update Date | 21/05/2013 |