| Thomas Donald Soltau Jr, MD | |
| 
					4600 Ambassador Caffery Pkwy, Lafayette, LA 70508-6902  | |
| (337) 470-5627 | |
| (337) 521-9128 | 
| Full Name | Thomas Donald Soltau Jr | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics - Neonatal-perinatal Medicine | 
| Location | 4600 Ambassador Caffery Pkwy, 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 | 
|---|---|---|---|
| 1275583858 | NPI | - | NPPES | 
| 2411543 | Medicaid | LA | |
| 00159819 | Medicaid | MS | 
| Entity Name | Our Lady Of The Lake Physician Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Thomas Donald Soltau Jr, MD 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (337) 470-5627  | Thomas Donald Soltau Jr, MD 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508-6902 Ph: (337) 470-5627  | 
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  |