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General NPI Number Information
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NPI Number | 1548448749
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Entity Type | Organization
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Legal Business Name | ACADIANA PATHOLOGY SERVICES (AMC)
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 419 E PRUDHOMME LN
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City | OPELOUSAS
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State | LA
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Zip | 70570-6445
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Country | US
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Telephone | 337-948-8206
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Fax | 337-948-8237
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Provider Business Mailing Address
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Address Line | PO BOX 52607
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City | LAFAYETTE
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State | LA
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Zip | 70505-2607
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Country | US
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Telephone | 337-233-5711
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Fax | 337-233-3618
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD N PADGETT
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Credential | M.D.
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Telephone | 337-948-8206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 19D1073946
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License Number State | LA
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