Provider Demographics
NPI:1629184635
Name:ABADCO, DOREEN T (MD)
Entity Type:Individual
Prefix:DR
First Name:DOREEN
Middle Name:T
Last Name:ABADCO
Suffix:
Gender:F
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:PO BOX 80384
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70598-0384
Mailing Address - Country:US
Mailing Address - Phone:337-269-5600
Mailing Address - Fax:337-269-5812
Practice Address - Street 1:114 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2825
Practice Address - Country:US
Practice Address - Phone:337-269-5600
Practice Address - Fax:337-269-5812
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11594R207LP2900X
PAMD-050174-L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1679224Medicaid
LA5W771Medicare ID - Type Unspecified
LAG25662Medicare UPIN