Provider Demographics
NPI:1447378617
Name:THE ARTHRITIS AND DIABETES CLINIC INC
Entity Type:Organization
Organization Name:THE ARTHRITIS AND DIABETES CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MADURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RANGARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-388-5830
Mailing Address - Street 1:PO BOX 4083
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71211-4083
Mailing Address - Country:US
Mailing Address - Phone:318-388-5830
Mailing Address - Fax:318-322-1249
Practice Address - Street 1:3402 MAGNOLIA CV
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-2374
Practice Address - Country:US
Practice Address - Phone:318-388-5830
Practice Address - Fax:318-322-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD. 05877R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty