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General NPI Number Information
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NPI Number | 1447625736
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Entity Type | Organization
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Legal Business Name | LANDRENEAU THORACIC SURGICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 12/11/2015
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Last Update Date | 12/11/2015
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Provider Practice Location Address
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Address Line | 600 MEDICAL ARTS BLDG SUITE 660
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City | KITTANNING
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State | PA
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Zip | 16201-7134
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Country | US
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Telephone | 724-548-3813
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Fax | 724-548-3814
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Provider Business Mailing Address
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Address Line | 600 MEDICAL ARTS BLDG SUITE 660
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City | KITTANNING
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State | PA
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Zip | 16201-7134
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Country | US
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Telephone | 724-548-3813
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Fax | 724-548-3814
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Authorized Official
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Title or Position | M.D.
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Name | RODNEY LANDRENEAU
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Credential | M.D.
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Telephone | 724-548-3813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | MD42702L
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License Number State | PA
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