Provider Demographics
NPI:1134116064
Name:GEORGE JUDE BARES MD APMC
Entity Type:Organization
Organization Name:GEORGE JUDE BARES MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-261-5151
Mailing Address - Street 1:PO BOX 81885
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70598-1885
Mailing Address - Country:US
Mailing Address - Phone:337-988-2345
Mailing Address - Fax:
Practice Address - Street 1:4650 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6926
Practice Address - Country:US
Practice Address - Phone:337-988-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1662917Medicaid
LA5DB96Medicare PIN