Organization
CENLA LASER CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JYOTI BAS GANJI M.D. (OWNER)
(318) 445-8181
Entity
Organization
Contact information
Practice address
3311 PRESCOTT ROAD, 312 CABRINI DOCTORS BUILDING, ALEXANDRIA, LA 71301
(318) 445-8181
(318) 445-6575
Mailing address
3311 PRESCOTT ROAD, 312 CABRINI DOCTORS BUILDING, ALEXANDRIA, LA 71301
(318) 445-8181
(318) 445-6575
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1979627
—
LA
01
—
377820091
BCBS
LA
Enumeration date
07/07/2008
Last updated
07/07/2008
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