Provider Demographics
NPI:1417997834
Name:CARDIOLOGY ASSOCIATES OF CENTRAL LA
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF CENTRAL LA
Other - Org Name:CARDIOLOGY ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:LANDRENEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-442-8698
Mailing Address - Street 1:201 4TH ST
Mailing Address - Street 2:SUITE 3 B
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8421
Mailing Address - Country:US
Mailing Address - Phone:318-442-8698
Mailing Address - Fax:318-442-1358
Practice Address - Street 1:201 4TH ST
Practice Address - Street 2:SUITE 3 B
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8421
Practice Address - Country:US
Practice Address - Phone:318-442-8698
Practice Address - Fax:318-442-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL015060207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA57886Medicare ID - Type UnspecifiedGROUP NUMBER