Healthcare Provider Details

I. General information

NPI: 1578513149
Provider Name (Legal Business Name): LAFAYETTE ARTHRITIS AND ENDOCRINE CLINIC APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 W CONGRESS ST STE 2300A
LAFAYETTE LA
70506-6778
US

IV. Provider business mailing address

4212 W CONGRESS ST STE 2300A
LAFAYETTE LA
70506-6778
US

V. Phone/Fax

Practice location:
  • Phone: 337-237-7801
  • Fax: 337-235-1865
Mailing address:
  • Phone: 337-237-7801
  • Fax: 337-235-1865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS SUSANNE VASSEUR
Title or Position: OFFICE MANAGER
Credential:
Phone: 337-237-7801