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General NPI Number Information
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NPI Number | 1083714836
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Entity Type | Individual
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Provider Name | HARI BOGABATHINA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/28/2024
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Provider Practice Location Address
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Address Line | 433 LA NEUVILLE RD
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-5212
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Country | US
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Telephone | 337-516-2800
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Fax | 337-516-2801
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Provider Business Mailing Address
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Address Line | 605 SILVERSTONE RD UNIT 212B
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City | LAFAYETTE
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State | LA
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Zip | 70508-6799
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Country | US
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Telephone | 440-781-7978
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Fax | 337-516-2801
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD.206078
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License Number State | LA
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