Provider Demographics
NPI:1992123228
Name:GAUDET, TIMOTHY PETER JR
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:PETER
Last Name:GAUDET
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 WESTBANK EXPRESSWAY
Mailing Address - Street 2:SUITE H
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:877-351-2117
Practice Address - Street 1:7521 WESTBANK EXPRESSWAY
Practice Address - Street 2:SUITE H
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-914-2117
Practice Address - Fax:877-351-2117
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies