Provider Demographics
NPI:1407877350
Name:HARWOOD, ANDREW R, (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:R,
Last Name:HARWOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4809 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8800
Mailing Address - Country:US
Mailing Address - Phone:337-769-8660
Mailing Address - Fax:337-769-8661
Practice Address - Street 1:4809 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8800
Practice Address - Country:US
Practice Address - Phone:337-769-8660
Practice Address - Fax:337-769-8661
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2016-03-09
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Provider Licenses
StateLicense IDTaxonomies
LA06638R2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1348007Medicaid
LA06638ROtherSTATE MEDICAL LICENSE
LA5DX68OtherONCOLOGICS LLC PTAN GROUP
LA5M543DD21OtherPTAN 3 OF 3: EFF 04-28-08
LA5M543DX68OtherANDREW HARWOOD MEDICARE PTAN EFFECTIVE 05/19/2012
LA5M543DX68OtherPTAN 1 OF 3: EFF 04-30-12
LA5M543C895OtherPTAN 2 OF 3: EFF 01-19-04
LA1348007Medicaid