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Organization
A T ORDINARIO JR MD LLC
Active
Organization
A T ORDINARIO JR MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANACLETO T ORDINARIO JR. M.D. (M.D.)
(337) 439-5369
Entity
Organization
Contact information
Practice address
435 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5874
(337) 439-5369
(337) 436-9998
Mailing address
435 DR MICHAEL DEBAKEY DR, LAKE CHARLES, LA 70601-5874
(337) 439-5369
(337) 436-9998
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD4229R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1183288
—
LA
01
—
54507
MEDICARE INDIVIDUAL PROVIDER NUMBER
—
01
—
54507DC33
MEDICARE PROVIDER NUMBER THAT LINKS INDIVIDUAL TO GROUP
—
01
—
5DC33
MEDICARE GROUP PROVIDER NUMBER
—
Enumeration date
01/17/2008
Last updated
12/03/2009
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