Healthcare Provider Details

I. General information

NPI: 1679416283
Provider Name (Legal Business Name): ACADIANA RADIOLOGY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 E MAIN ST
NEW IBERIA LA
70560-4031
US

IV. Provider business mailing address

PO BOX 4628
JACKSON MS
39296-4628
US

V. Phone/Fax

Practice location:
  • Phone: 337-264-0461
  • Fax: 706-596-6704
Mailing address:
  • Phone: 866-264-3435
  • Fax: 706-596-6704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: GERARD A. BALLANCO JR.
Title or Position: DIRECTOR
Credential: MD
Phone: 337-264-0441