Fautheree, Gregory Lee

Fautheree, Gregory Lee is an individual health care provider with primary practice located at 10101 Park Rowe Ave Ste 200 , Baton Rouge LA 70810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Fautheree, Gregory Lee can be contacted via phone (225) 769-2200.

Contact Information

Primary practice address
10101 Park Rowe Ave Ste 200 Baton Rouge LA 70810
Fax: (225) 768-2185
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X MD.203804 Louisiana
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X TRN6823 Florida
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X ME105666 Florida

Profile Details

NPI number 1942385703
LBN Legal business name Fautheree, Gregory Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Mar 25th, 2020 - about 4 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 1942385703 NPPES
Louisiana MEDICAID 2112562
Louisiana MEDICAID 001635000

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