Organization
MATERNAL FETAL MEDICINE OF ACADIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL K. DIBBS M.D. (OWNER)
(337) 942-1151
Entity
Organization
Contact information
Practice address
105 CORPORATE BLVD, LAFAYETTE, LA 70508-3850
(337) 593-9099
(337) 948-4392
Mailing address
PO BOX 51742, LAFAYETTE, LA 70505-1742
(337) 593-9099
(337) 948-4392
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
11220R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447757
—
LA
Enumeration date
06/11/2005
Last updated
10/31/2008
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