Provider Demographics
NPI:1174571798
Name:MONTEGUT, CHRISTY A (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:A
Last Name:MONTEGUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 W AIRLINE HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3817
Mailing Address - Country:US
Mailing Address - Phone:985-652-3344
Mailing Address - Fax:985-652-9320
Practice Address - Street 1:429 W AIRLINE HWY
Practice Address - Street 2:SUITE B
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3817
Practice Address - Country:US
Practice Address - Phone:985-652-3344
Practice Address - Fax:985-652-9320
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA014286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1303542Medicaid
LAB65591Medicare UPIN
LA1303542Medicaid