Provider Demographics
NPI:1114976248
Name:ACADIANA IMAGING AND DIAGNOSTICS
Entity Type:Organization
Organization Name:ACADIANA IMAGING AND DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:WARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-457-8040
Mailing Address - Street 1:PO BOX 1288
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-1288
Mailing Address - Country:US
Mailing Address - Phone:337-824-4403
Mailing Address - Fax:337-824-9731
Practice Address - Street 1:711 E LAUREL AVE
Practice Address - Street 2:STE D
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-3515
Practice Address - Country:US
Practice Address - Phone:337-457-2673
Practice Address - Fax:337-457-2617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory