Provider Demographics
NPI:1235324831
Name:ACADIANA AMBULATORY HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:ACADIANA AMBULATORY HEALTH CARE SERVICES, INC.
Other - Org Name:WALK IN CLINIC, STAFFORD HEALTHCARE CLINICS, STAFFORD OCCUPATIONAL, SE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-981-6811
Mailing Address - Street 1:207 WESTMARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-7365
Mailing Address - Country:US
Mailing Address - Phone:337-981-6811
Mailing Address - Fax:337-981-2024
Practice Address - Street 1:207 WESTMARK BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7365
Practice Address - Country:US
Practice Address - Phone:337-981-6811
Practice Address - Fax:337-981-2024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty