Provider Demographics
NPI:1568615268
Name:ACADIAN PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:ACADIAN PHYSICIAN PRACTICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JESS
Authorized Official - Middle Name:N
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-8500
Mailing Address - Street 1:3501 HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-5129
Mailing Address - Country:US
Mailing Address - Phone:337-580-7500
Mailing Address - Fax:
Practice Address - Street 1:151 HILL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-5845
Practice Address - Country:US
Practice Address - Phone:337-457-8061
Practice Address - Fax:337-457-4392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202530208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty