Healthcare Provider Details

I. General information

NPI: 1417109000
Provider Name (Legal Business Name): RIVER PARISH SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 10/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 RUE DE SANTE SUITE 5
LA PLACE LA
70068-5400
US

IV. Provider business mailing address

501 RUE DE SANTE SUITE 5
LA PLACE LA
70068-5400
US

V. Phone/Fax

Practice location:
  • Phone: 985-652-1059
  • Fax: 985-652-1069
Mailing address:
  • Phone: 985-652-1059
  • Fax: 985-652-1069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES J MCGAFF
Title or Position: PRESIDENT
Credential: M.D.
Phone: 985-652-1059