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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720241276 NPPES
Mississippi MEDICAID 08471706
Mississippi MEDICAID 2304402

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