MEDICARE: ALEXANDRIA GASTROENTEROLOGY ASSOCIATES INC

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	207RG0100X	Gastroenterology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CN3551	OTHER	LA	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	43127	OTHER	LA	BLUE CROSS BLUE SHEILD GR
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417930447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDRIA GASTROENTEROLOGY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	301 4TH ST
Second Line	:	BOX 30146
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301
Country	:	US
Telephone Number	:	318-473-8188
Fax Number	:	318-473-8682

Provider Business Practice Location Address
First Line	:	301 4TH ST
Second Line	:	SUITE 1-A
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-8423
Country	:	US
Telephone Number	:	318-473-8188
Fax Number	:	318-473-8682

Authorized Official
Title or Position	:	PRESIDENT OF ORGANIZATION MD
Name	:	DR. JOSEPH DRAKE HOLLIER
Credential	:	MD
Telephone Number	:	318-473-8188

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	02/11/2011

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Practice Location Address:

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Directions to “ALEXANDRIA GASTROENTEROLOGY ASSOCIATES INC ” Practice Location

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