Healthcare Provider Details

I. General information

NPI: 1669917795
Provider Name (Legal Business Name): JAD ARIDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2016
Last Update Date: 12/09/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70508
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 337-470-4595
  • Fax: 337-470-2605
Mailing address:
  • Phone: 337-470-4595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMT212321
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number329170
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: