Organization
SOUTHWEST REGIONAL BREAST CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A BOLIN M.D. (GENERAL SURGEON)
(337) 989-8770
Entity
Organization
Contact information
Practice address
4630 AMBASSADOR CAFFERY PKWY, STE 406, LAFAYETTE, LA 70508-6949
(337) 989-8770
(337) 989-8768
Mailing address
4630 AMBASSADOR CAFFERY PKWY, STE 406, LAFAYETTE, LA 70508-6949
(337) 989-8770
(337) 989-8768
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
010571
LA
Other
Enumeration date
03/11/2007
Last updated
08/22/2020
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