# MED ED OF LOUISIANA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114086576
- **Authorized official:** DR. JAHANYAR KHORSANDI M.D. (PRESIDENT)
- **Authorized official phone:** (337) 332-0222

## Contact information

- **Practice address:** 209 CHAMPAGNE BLVD., BREAUX BRIDGE, LA 70517-3700
- **Practice address phone:** (337) 332-0222
- **Practice address fax:** (337) 332-1102
- **Mailing address:** 209 CHAMPAGNE BLVD, BREAUX BRIDGE, LA 70517-3700
- **Mailing address phone:** (337) 332-0222
- **Mailing address fax:** (337) 332-1102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 023722 | LA | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 12/31/2015