Individual
HAMID KAKAVANDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
420 S VINE ST, BASTROP, LA 71220
(318) 283-3955
(318) 239-8955
Mailing address
PO BOX 293, BASTROP, LA 71221-0293
(318) 283-3955
(318) 239-8955
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
03405
IA
208600000X
Surgery Physician
Primary
321115
LA
Other
Enumeration date
10/02/2006
Last updated
10/09/2019
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