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General NPI Number Information
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NPI Number | 1063124568
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Entity Type | Organization
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Legal Business Name | LAFAYETTE HEALTH VENTURES INC
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Dates
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Enumeration Date | 12/16/2022
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 1634 ELTON RD
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City | JENNINGS
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State | LA
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Zip | 70546-3614
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Country | US
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Telephone | 337-289-8944
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 919229
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City | DALLAS
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State | TX
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Zip | 75391-9229
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | KIM DOOLEY
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Credential |
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Telephone | 337-571-1394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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