Organization
LACIE ALFONSO MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LACIE A ALFONSO MD (DIRECTOR)
(337) 233-7977
Entity
Organization
Contact information
Practice address
4801 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70508-6917
(337) 233-7977
(337) 233-7978
Mailing address
PO BOX 80965, LAFAYETTE, LA 70598-0965
(337) 233-7977
(337) 233-7978
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA5900
MEDICARE RAILROAD
LA
Enumeration date
05/19/2006
Last updated
09/30/2014
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