Provider Demographics
NPI:1679615702
Name:REYNAUD, MARILYN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:MARIE
Last Name:REYNAUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARILYN
Other - Middle Name:MATIE
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7173A FLORIDA BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4549
Mailing Address - Country:US
Mailing Address - Phone:225-925-3842
Mailing Address - Fax:225-925-7245
Practice Address - Street 1:7173A FLORIDA BOULEVARD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4549
Practice Address - Country:US
Practice Address - Phone:225-925-3842
Practice Address - Fax:225-925-7245
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD 05293R207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology