Provider Demographics
NPI:1508893801
Name:LAKSHMIPRASAD, PADUMANE (MD)
Entity Type:Individual
Prefix:DR
First Name:PADUMANE
Middle Name:
Last Name:LAKSHMIPRASAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 JEFFERSON ST STE 404
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6991
Mailing Address - Country:US
Mailing Address - Phone:337-233-2535
Mailing Address - Fax:337-235-0157
Practice Address - Street 1:4630 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:STE 205
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6951
Practice Address - Country:US
Practice Address - Phone:337-233-2535
Practice Address - Fax:337-235-0157
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06157R207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1332739Medicaid
LA1332739Medicaid
B64750Medicare UPIN
LA53642Medicare PIN