| Doctor Name: | WILBUR G BEAUREGARD |
| NPI Number: | 1104994946 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 008723 |
| Business Practice Address: | 100 Price Dr West Monroe, LA - 712926315 |
| Business Phone Number: | 3183250973 |
| Business Fax Number: | 3183619323 |
| Mailing Address: | 1101 Mcmillan Rd, WEST MONROE |
| State: | LA |
| Postal Code: | 712917337 |
| Phone Number: | 3183968507 |
| Fax Number: | 3183619323 |
| NPI Enumeration Date: | 12/01/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | 008723 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |