Healthcare Provider Details

I. General information

NPI: 1104984293
Provider Name (Legal Business Name): LOUISIANA CARDIOVASCULAR & THORACIC INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 PRESCOTT RD STE 202
ALEXANDRIA LA
71301-3983
US

IV. Provider business mailing address

3311 PRESCOTT RD STE 202
ALEXANDRIA LA
71301-3983
US

V. Phone/Fax

Practice location:
  • Phone: 318-442-0106
  • Fax: 318-448-8918
Mailing address:
  • Phone: 318-442-0106
  • Fax: 318-448-8918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateLA

VIII. Authorized Official

Name: DR. GARY P JONES
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 318-442-0106