Healthcare Provider Details

I. General information

NPI: 1861955916
Provider Name (Legal Business Name): MEGHANA PATTIPATI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2019
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 COOLIDGE BLVD
LAFAYETTE LA
70503-2636
US

IV. Provider business mailing address

1211 COOLIDGE BLVD
LAFAYETTE LA
70503-2636
US

V. Phone/Fax

Practice location:
  • Phone: 337-703-6383
  • Fax: 337-703-6384
Mailing address:
  • Phone: 337-703-6383
  • Fax: 337-703-6384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number347613
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: