| Dr Derek B Baumbouree, MD | |
| 
					324 E Farrel Rd, Lafayette, LA 70508-6928  | |
| (337) 470-6590 | |
| (337) 470-6595 | 
| Full Name | Dr Derek B Baumbouree | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics | 
| Location | 324 E Farrel Rd, Lafayette, Louisiana | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1265430995 | NPI | - | NPPES | 
| 1493708 | Medicaid | LA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 022823 (Louisiana) | Primary | 
| Entity Name | Lourdes Physician Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1437405883 PECOS PAC ID: 7214177757 Enrollment ID: O20130705000541  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Derek B Baumbouree, MD 4809 Ambassador Caffery Pkwy, Suite 200, Lafayette, LA 70508-6917 Ph: (337) 984-2444  | Dr Derek B Baumbouree, MD 324 E Farrel Rd, Lafayette, LA 70508-6928 Ph: (337) 470-6590  | 
Dr. Sheung Man Alexander Sin, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2390 W Congress St, Lafayette, LA 70506 Phone: 615-322-5000  | |
Karl M. Valcourt, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-2605  | |
Neva Ducote Seago, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4600 Ambassador Caffery Pkwy, Women's And Children's Hospital, Lafayette, LA 70508 Phone: 337-521-9100  | |
Dr. Colleen C Sicard, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 200 Beaullieu Dr Ste 7, Lafayette, LA 70508 Phone: 337-366-8616 Fax: 337-366-8133  | |
Ashish Mavjibhai Goti, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-2605 Fax: 337-470-4595  | |
Dr. Virginia B Coreil, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 5000 Ambassador Caffery Pkwy Bldg 12, Lafayette, LA 70508 Phone: 337-470-3150 Fax: 337-470-3161  | |
Dr. Ebenezer S. Bediako, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-5500 Fax: 337-521-9166  |