Godeaux, Lacey Mathilda
Godeaux, Lacey Mathilda is an individual health care provider with primary practice located at 1202 S Tyler St , Covington LA 70433-2330. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Godeaux, Lacey Mathilda can be contacted via phone (985) 892-3225.Contact Information
Primary practice address
1202 S Tyler St
Covington LA 70433-2330
Phone: (985) 892-3225
Fax: (985) 892-7677
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | LL30817 | South Carolina |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 205372 | Louisiana |
Profile Details
| NPI number | 1720241276 |
|---|---|
| LBN Legal business name | Godeaux, Lacey Mathilda |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2008 |
| Last updated | Dec 20th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720241276 | NPPES |
| Mississippi | MEDICAID | 08471706 | |
| Mississippi | MEDICAID | 2304402 |
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