Provider Demographics
NPI:1376552414
Name:NATH & ASSOCIATES LLC
Entity Type:Organization
Organization Name:NATH & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GOPINATH
Authorized Official - Middle Name:
Authorized Official - Last Name:KONGARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-767-3710
Mailing Address - Street 1:5425 BRITTANY DR
Mailing Address - Street 2:STE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-9144
Mailing Address - Country:US
Mailing Address - Phone:225-767-3710
Mailing Address - Fax:225-767-8255
Practice Address - Street 1:5425 BRITTANY DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9144
Practice Address - Country:US
Practice Address - Phone:225-767-3710
Practice Address - Fax:225-767-8255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2006392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448737Medicaid
LAI53342Medicare UPIN
LA1448737Medicaid