Individual
VICTOR E TEDESCO IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
155 HOSPITAL DR STE 201, LAFAYETTE, LA 70503-2852
(337) 289-7999
(337) 289-7998
Mailing address
5000 AMBASSADOR CAFFERY PKWY, PROVINCE BLDG. 14-A, LAFAYETTE, LA 70508-6984
(337) 234-7779
(337) 235-7246
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020027313
RR MEDICARE
LA
05
—
1385794
—
LA
Enumeration date
07/20/2006
Last updated
04/16/2019
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