Healthcare Provider Details

I. General information

NPI: 1588667257
Provider Name (Legal Business Name): CAIN & JOHNSON ONCOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 HOSPITAL DR STE 100
LAFAYETTE LA
70503-2852
US

IV. Provider business mailing address

PO BOX 52028
LAFAYETTE LA
70505-2028
US

V. Phone/Fax

Practice location:
  • Phone: 337-354-0030
  • Fax: 337-354-0026
Mailing address:
  • Phone: 337-354-0030
  • Fax: 337-354-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number021976
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number021651
License Number StateLA

VIII. Authorized Official

Name: MICHAEL S CAIN
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 337-354-0030