Healthcare Provider Details

I. General information

NPI: 1639138522
Provider Name (Legal Business Name): ACADIAN EAR NOSE THROAT & FACIAL PLASTIC SURGERY (APMC)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W PINHOOK RD SUITE 201
LAFAYETTE LA
70503-2460
US

IV. Provider business mailing address

1000 W PINHOOK RD SUITE 201
LAFAYETTE LA
70503-2460
US

V. Phone/Fax

Practice location:
  • Phone: 337-237-0650
  • Fax: 888-990-2781
Mailing address:
  • Phone: 337-237-0650
  • Fax: 888-990-2781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY J CHASTANT
Title or Position: PRESIDENT
Credential: MD
Phone: 337-237-0650