Healthcare Provider Details

I. General information

NPI: 1780929604
Provider Name (Legal Business Name): PARADIGM HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2012
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64301 HIGHWAY 434
LACOMBE LA
70445-5411
US

IV. Provider business mailing address

64301 HIGHWAY 434
LACOMBE LA
70445-5411
US

V. Phone/Fax

Practice location:
  • Phone: 985-882-4500
  • Fax: 985-882-4501
Mailing address:
  • Phone: 985-882-4500
  • Fax: 985-882-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. TOM GRESSAFFA
Title or Position: COO
Credential:
Phone: 985-882-4500