Bergeron, Edmond X

Bergeron, Edmond X is an individual health care provider with primary practice located at 806 Jefferson Ter , New Iberia LA 70560-5727. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Prescribing (Medical). Behavioral Health & Social Service Providers / Prescribing (Medical) is his primary health care specialty. Bergeron, Edmond X can be contacted via phone (337) 365-4945.

Contact Information

Primary practice address
806 Jefferson Ter New Iberia LA 70560-5727
Phone: (337) 365-4945
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 606MP Louisiana
Behavioral Health & Social Service Providers / Prescribing (Medical) 103TP0016X 606MP Louisiana

Profile Details

NPI number 1235211798
LBN Legal business name Bergeron, Edmond X
Credentials M.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2006
Last updated Oct 22nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235211798 NPPES
Louisiana MEDICAID 1660841

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