Provider Demographics
NPI:1609867191
Name:OBSTETRICAL & GYNECOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:OBSTETRICAL & GYNECOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:318-448-3210
Mailing Address - Street 1:3335 PRESCOTT RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3916
Mailing Address - Country:US
Mailing Address - Phone:318-448-3210
Mailing Address - Fax:318-443-4874
Practice Address - Street 1:3335 PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3916
Practice Address - Country:US
Practice Address - Phone:318-448-3210
Practice Address - Fax:318-443-4874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAV1135313OtherDEA