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General NPI Number Information
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NPI Number | 1114035946
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Entity Type | Organization
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Legal Business Name | ACADIANA ENDOSCOPY CENTER, INC.
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 1211 COOLIDGE BLVD SUITE 302
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City | LAFAYETTE
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State | LA
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Zip | 70503-2636
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Country | US
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Telephone | 337-289-8249
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Fax | 337-289-8246
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Provider Business Mailing Address
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Address Line | P.O. BOX 52328
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City | LAFAYETTE
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State | LA
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Zip | 70505-2328
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Country | US
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Telephone | 337-735-7317
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Fax | 337-988-6487
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JACQUE F NOEL
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Credential | MD
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Telephone | 337-735-7317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 166
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License Number State | LA
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