Organization
IBERIA GENERAL HOSPITAL AND MEDICAL CENTER
Active
Parent organization
IBERIA GENERAL HOSPITAL AND MEDICAL CENTER
Other names
Endocrinology Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
IBERIA GENERAL HOSPITAL AND MEDICAL CENTER
Authorized official
MR. JOHN A TUCKER FACHE (PRESIDENT/CHIEF EXECUTIVE OFFICER)
(337) 374-7104
Entity
Organization
Contact information
Practice address
2205 OLD JEANERETTE RD, NEW IBERIA, LA 70563-8687
(337) 560-1992
(337) 364-9102
Mailing address
PO BOX 10539, NEW IBERIA, LA 70562-0539
(337) 560-1992
(337) 364-9102
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
115
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN9239
MEDICARE RAILROAD GROUP
LA
Enumeration date
08/25/2006
Last updated
06/18/2008
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