Organization
LOURDES PATHOLOGISTS APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIDNEY B GRAY MD (MANAGING MEMBER)
(227) 234-3659
Entity
Organization
Contact information
Practice address
611 SAINT LANDRY ST, LAFAYETTE, LA 70506-4627
(337) 234-3659
(337) 232-6962
Mailing address
PO BOX 52545, LAFAYETTE, LA 70505-2545
(337) 234-3659
(337) 232-6962
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1443794
—
LA
Enumeration date
07/15/2006
Last updated
03/31/2008
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