Provider Demographics
NPI:1194095109
Name:GERARD F. SIGUE MD, MS, LLC
Entity type:Organization
Organization Name:GERARD F. SIGUE MD, MS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-331-5672
Mailing Address - Street 1:217 GLENEAGLES CIR
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-6185
Mailing Address - Country:US
Mailing Address - Phone:337-331-5672
Mailing Address - Fax:
Practice Address - Street 1:2308 E MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-4041
Practice Address - Country:US
Practice Address - Phone:337-608-9043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty