Doctor Name: | DR. THOMAS GREGORY CHAISSON |
NPI Number: | 1902895279 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 09201R |
Business Practice Address: | 142 Rue Marguerite Thibodaux, LA - 703016738 |
Business Phone Number: | 9854462131 |
Business Fax Number: | 9854473383 |
Mailing Address: | 142 Rue Marguerite, Suite B THIBODAUX |
State: | LA |
Postal Code: | 703014957 |
Phone Number: | 9854462131 |
Fax Number: | 9854473383 |
NPI Enumeration Date: | 10/19/2005 |
NPI Last Update Date: | 11/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 09201R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |