Healthcare Provider Details

I. General information

NPI: 1043595804
Provider Name (Legal Business Name): SURGICAL HOSPITAL MANAGEMENT SYSTEM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 PINHOOK ROAD SUITE 310
LAFAYETTE LA
70503-2460
US

IV. Provider business mailing address

1000 PINHOOK ROAD SUITE 310
LAFAYETTE LA
70503-2460
US

V. Phone/Fax

Practice location:
  • Phone: 337-233-9900
  • Fax: 337-233-0770
Mailing address:
  • Phone: 337-233-9900
  • Fax: 337-233-0770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILIP GACHASSIN
Title or Position: MEMBER
Credential: M.D.
Phone: 337-233-9900