Healthcare Provider Details

I. General information

NPI: 1437208840
Provider Name (Legal Business Name): ALLERGY ASTHMA & IMMUNOLOGY CENTER OF SOUTHWEST LOUISIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SETTLERS TRACE BLVD
LAFAYETTE LA
70508
US

IV. Provider business mailing address

320 SETTLERS TRACE BLVD
LAFAYETTE LA
70508-6060
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-9495
  • Fax: 337-981-7451
Mailing address:
  • Phone: 337-981-9495
  • Fax: 337-981-7451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. CINDY WILKINSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 337-981-9495