Healthcare Provider Details

I. General information

NPI: 1780616094
Provider Name (Legal Business Name): ABBEVILLE GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 N HOSPITAL DR
ABBEVILLE LA
70510-4039
US

IV. Provider business mailing address

PO BOX 52662
LAFAYETTE LA
70505-2662
US

V. Phone/Fax

Practice location:
  • Phone: 337-893-5466
  • Fax:
Mailing address:
  • Phone: 337-893-5466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. RAY LANDRY
Title or Position: CEO
Credential:
Phone: 337-893-5466