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1770634628
GERALD WADE MOUTON
LAKE CHARLES, LA
NPI
1770634628
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 018271)
Enumeration Date
2007-01-16
Last Update Date
2022-05-12
Business Address
Dr. GERALD WADE MOUTON MD
2750 ASTER ST
LAKE CHARLES, LA 70601-8824
Phone number: 337-480-8900
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Mailing Address
Dr. GERALD WADE MOUTON MD
PO BOX 122539 DEPT 2539
DALLAS, TX 75312-2539
Phone number: 337-494-2921
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