Provider Demographics
NPI:1588914436
Name:GAGNE, RONALD JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:JOSEPH
Last Name:GAGNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 TOULOUSE ST
Mailing Address - Street 2:UNIT BC-1
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-3479
Mailing Address - Country:US
Mailing Address - Phone:504-558-9673
Mailing Address - Fax:504-558-9673
Practice Address - Street 1:1022 TOULOUSE ST
Practice Address - Street 2:UNIT BC-1
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-558-9673
Practice Address - Fax:504-558-9673
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.12831R207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice