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General NPI Number Information
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NPI Number | 1215167283
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Entity Type | Organization
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Legal Business Name | RACHAEL A TATE MD LLC
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Dates
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Enumeration Date | 07/23/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 1270 ATTAKAPAS DR SUITE 402
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City | OPELOUSAS
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State | LA
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Zip | 70570-6549
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Country | US
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Telephone | 337-948-4030
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Fax | 337-948-2008
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Provider Business Mailing Address
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Address Line | 1270 ATTAKAPAS DR SUITE 402
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City | OPELOUSAS
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State | LA
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Zip | 70570-6549
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Country | US
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Telephone | 337-948-4030
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Fax | 337-948-2008
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Authorized Official
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Title or Position | OWNER / OPERATOR
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Name | DR. RACHAEL A TATE
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Credential | MD
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Telephone | 337-948-4030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 201217
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License Number State | LA
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