# SOUTHERN VASCULAR ASSOCIATES LLC

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

## Provider details

- **NPI number:** 1578942512
- **Authorized official:** MR. RACHEED JOSEPH GHANAMI M.D. (PHYSICIAN)
- **Authorized official phone:** (337) 356-1252

## Contact information

- **Practice address:** 127 QUEENSBERRY DR, LAFAYETTE, LA 70508-5421
- **Practice address phone:** (337) 356-1252
- **Mailing address:** 127 QUEENSBERRY DR, LAFAYETTE, LA 70508-5421
- **Mailing address phone:** (337) 356-1252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 205214 | LA | Yes |

## Other

- **Enumeration date:** 05/22/2015
- **Last updated:** 05/22/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2315617 | — | LA |