Individual
JUDE A AGENDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 WALTERS STREET, LAKE CHARLES, LA 70607
(337) 475-8429
(337) 475-8415
Mailing address
PO BOX 4610, LAKE CHARLES, LA 70606-4610
(337) 312-1446
(337) 312-1490
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
201634
LA
207Q00000X
Family Medicine Physician
Primary
201634
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015539
—
LA
Enumeration date
10/16/2007
Last updated
11/01/2010
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