Provider Demographics
NPI:1639138522
Name:ACADIAN EAR NOSE THROAT & FACIAL PLASTIC SURGERY (APMC)
Entity Type:Organization
Organization Name:ACADIAN EAR NOSE THROAT & FACIAL PLASTIC SURGERY (APMC)
Other - Org Name:BRADLEY J CHASTANT MD FACS APMC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHASTANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-237-0650
Mailing Address - Street 1:1000 W PINHOOK RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2460
Mailing Address - Country:US
Mailing Address - Phone:337-237-0650
Mailing Address - Fax:888-990-2781
Practice Address - Street 1:1000 W PINHOOK RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2460
Practice Address - Country:US
Practice Address - Phone:337-237-0650
Practice Address - Fax:888-990-2781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CA42Medicare PIN