Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 058025 | GA |
NPI | 1003833955 |
---|---|
Provider Name | Karl M. Valcourt |
First Address | Lafayette, LA 70508-6902 |
Second Address | Lafayette, LA 70508-6902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 18/04/2011 |