Basic Information
| Provider Information | |||||||||
| NPI: | 1801848015 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARISH ANESTHESIA OF LAFAYETTE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 744 W MICHIGAN AVE | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492011909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002421131 | ||||||||
| FaxNumber: | 5177874146 | ||||||||
| Practice Location | |||||||||
| Address1: | 3510 N CAUSEWAY BLVD | ||||||||
| Address2: | |||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700023531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5047795515 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DECORTE | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DELEGATED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 5047795515 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | X | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 174400000X | X | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.