Basic Information
| Provider Information | |||||||||
| NPI: | 1588667257 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAIN & JOHNSON ONCOLOGY LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LAFAYETTE HEMATOLOGY-ONCOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 52028 | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705052028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3373540030 | ||||||||
| FaxNumber: | 3373540026 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 HOSPITAL DR | ||||||||
| Address2: | STE 100 | ||||||||
| City: | LAFAYETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705032852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3373540030 | ||||||||
| FaxNumber: | 3373540026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 05/14/2008 | ||||||||
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| AuthorizedOfficialLastName: | CAIN | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 3373540030 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 021976 | LA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | 021651 | LA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 1446891 | 05 | LA | MEDICAID | DB9815 | 01 | LA | RAILROAD MEDICARE | OTHER |