Provider Demographics
NPI:1629057682
Name:CEFALU, FRANCIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:J
Last Name:CEFALU
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 1:309 WALNUT ST STE C
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-2055
Mailing Address - Country:US
Mailing Address - Phone:985-748-9801
Mailing Address - Fax:985-748-3948
Practice Address - Street 1:309 WALNUT ST STE C
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-2055
Practice Address - Country:US
Practice Address - Phone:985-748-9801
Practice Address - Fax:985-748-3948
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017657207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1355640Medicaid
52710Medicare ID - Type Unspecified
B64068Medicare UPIN
LAB64068Medicare UPIN