Organization
KENNETH J. CHAMPAGNE, M.D., APMC
Active
Other names
COLON AND RECTAL CLINIC OF ACADIANA
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SONDRA A. BERNARD RHIA (OFFICE MANAGER)
(337) 233-0219
Entity
Organization
Contact information
Practice address
102 DRURY LN, LAFAYETTE, LA 70508-5702
(337) 233-0219
(337) 233-2418
Mailing address
102 DRURY LN, LAFAYETTE, LA 70508-5702
(372) 233-0219
(337) 233-2418
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
017238
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396681
—
LA
01
—
DG9731
REILROAD MEDICARE
LA
Enumeration date
03/28/2006
Last updated
12/20/2019
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