Healthcare Provider Details

I. General information

NPI: 1609867191
Provider Name (Legal Business Name): OBSTETRICAL & GYNECOLOGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3335 PRESCOTT RD
ALEXANDRIA LA
71301-3916
US

IV. Provider business mailing address

3335 PRESCOTT RD
ALEXANDRIA LA
71301-3916
US

V. Phone/Fax

Practice location:
  • Phone: 318-448-3210
  • Fax: 318-443-4874
Mailing address:
  • Phone: 318-448-3210
  • Fax: 318-443-4874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. VINCENT VINCENT III
Title or Position: PHYSICIAN/PRESIDENT
Credential: MD
Phone: 318-448-3210