Basic Information
| Provider Information | |||||||||
| NPI: | 1578513149 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LAFAYETTE ARTHRITIS AND ENDOCRINE CLINIC APMC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4212 W CONGRESS ST STE 2300A | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705066778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372377801 | ||||||||
| FaxNumber: | 3372351865 | ||||||||
| Practice Location | |||||||||
| Address1: | 4212 W CONGRESS ST STE 2300A | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705066778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372377801 | ||||||||
| FaxNumber: | 3372351865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 07/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | VASSEUR | ||||||||
| AuthorizedOfficialFirstName: | SUSANNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3372377801 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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| NPICertificationDate: | 07/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RE0101X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.