Healthcare Provider Details

I. General information

NPI: 1093700015
Provider Name (Legal Business Name): JULIAN FERNANDO NARANJO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 KEYSER AVE
NATCHITOCHES LA
71457-6018
US

IV. Provider business mailing address

PO BOX 43
NATCHITOCHES LA
71458-0043
US

V. Phone/Fax

Practice location:
  • Phone: 318-214-4153
  • Fax:
Mailing address:
  • Phone: 954-526-5165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number348342
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: