IndividualActive
Dimitri Pagoulato, PAC
NPI 1194988915 · Physician Assistant · Baker, LA
Provider details
- NPI number
- 1194988915
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- License
- 200193 (LA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
6516 E Myrtle Ave
Baker, LA 70714-4348
Phone: (225) 774-7320
Fax: (225) 774-5432
Approximate (ZIP-level) locationGet directions
Mailing address
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Additional practice locations (1)
- 12525 Perkins RdSte. BBaton Rouge, LA 70810-1907Phone: (225) 819-8857Fax: (225) 767-6822
Registry dates
- Enumerated
- 2008-07-02
- Last updated
- 2025-03-14
- Certified
- 2025-03-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.