Provider Demographics
NPI:1639276850
Name:ACADIANA MATERNAL FETAL MEDICINE APMC
Entity Type:Organization
Organization Name:ACADIANA MATERNAL FETAL MEDICINE APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRST DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARRILLEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-989-9826
Mailing Address - Street 1:4630 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:STE 204
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6949
Mailing Address - Country:US
Mailing Address - Phone:337-989-9826
Mailing Address - Fax:337-989-9829
Practice Address - Street 1:4630 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:STE 204
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6949
Practice Address - Country:US
Practice Address - Phone:337-989-9826
Practice Address - Fax:337-989-9829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1445169Medicaid
LA1445169Medicaid