Organization
LAFAYETTE HEALTH VENTURES. INC
Active
Other names
OB-GYN Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KIRK VICE PRESIDENT (VICE PRESIDENT)
(338) 289-8951
Entity
Organization
Contact information
Practice address
1211 COOLIDGE BLVD, SUITE 404, LAFAYETTE, LA 70503-2636
(337) 289-8440
(337) 289-8442
Mailing address
PO BOX 53092, LAFAYETTE, LA 70505-3092
(338) 289-8976
(337) 289-8970
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1712426
—
LA
01
—
CG2600
RAILROAD MEDICARE
LA
Enumeration date
05/22/2006
Last updated
10/26/2011
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