Provider Demographics
NPI:1316935174
Name:ALLEMAND, PEGGY A (MD)
Entity type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:A
Last Name:ALLEMAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:KINDER
Mailing Address - State:LA
Mailing Address - Zip Code:70648-0280
Mailing Address - Country:US
Mailing Address - Phone:337-738-2713
Mailing Address - Fax:337-738-4167
Practice Address - Street 1:208 SIXTH AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:KINDER
Practice Address - State:LA
Practice Address - Zip Code:70648
Practice Address - Country:US
Practice Address - Phone:337-738-2713
Practice Address - Fax:337-738-4167
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016557207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1338231Medicaid
LA5M718Medicare ID - Type Unspecified