Healthcare Provider Details

I. General information

NPI: 1265627509
Provider Name (Legal Business Name): WOMENS MULTI-SPECIALTY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 07/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4630 AMBASSADOR CAFFERY PKWY SUITE 308
LAFAYETTE LA
70508-6949
US

IV. Provider business mailing address

4630 AMBASSADOR CAFFERY PKWY SUITE 308
LAFAYETTE LA
70508-6949
US

V. Phone/Fax

Practice location:
  • Phone: 337-989-8770
  • Fax: 337-989-8768
Mailing address:
  • Phone: 337-989-8770
  • Fax: 337-989-8768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JAMES M. REMETICH
Title or Position: VICE PRESIDENT
Credential:
Phone: 504-988-7507