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General NPI Number Information
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NPI Number | 1962610360
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Entity Type | Individual
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Provider Name | JUSTIN MICHAEL ARDOIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 4811 AMBASSADOR CAFFERY PKWY STE 401A
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City | LAFAYETTE
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State | LA
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Zip | 70508-7265
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Country | US
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Telephone | 337-470-3040
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Fax | 337-470-3052
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Provider Business Mailing Address
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Address Line | 4811 AMBASSADOR CAFFERY PKWY SUITE 305
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City | LAFAYETTE
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State | LA
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Zip | 70508-7265
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Country | US
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Telephone | 337-470-3040
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Fax | 337-470-3052
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 203201
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | PGY1
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License Number State | LA
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