MEDICARE: LAHASKY MEDICAL CLINIC APMC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194841098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAHASKY MEDICAL CLINIC APMC

Provider Business Mailing Address
First Line	:	2621 NORTH DR
Second Line	:	SUITE B
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-4042
Country	:	US
Telephone Number	:	337-898-1860
Fax Number	:	337-898-1862

Provider Business Practice Location Address
First Line	:	2621 NORTH DR
Second Line	:	SUITE B
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-4042
Country	:	US
Telephone Number	:	337-898-1860
Fax Number	:	337-898-1862

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RONALD MYRON LAHASKY
Credential	:	M.D.
Telephone Number	:	337-898-1860

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	08/09/2007

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