Provider Demographics
NPI:1639205388
Name:ACADIANA FOOT CENTERS LLC
Entity Type:Organization
Organization Name:ACADIANA FOOT CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GASPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-981-4001
Mailing Address - Street 1:203 W BRENTWOOD BLVD
Mailing Address - Street 2:STE 2
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6190
Mailing Address - Country:US
Mailing Address - Phone:337-981-4001
Mailing Address - Fax:337-981-5148
Practice Address - Street 1:203 W BRENTWOOD BLVD
Practice Address - Street 2:STE 2
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6190
Practice Address - Country:US
Practice Address - Phone:337-981-4001
Practice Address - Fax:337-981-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3951650001Medicare NSC