Provider Demographics
NPI:1659481489
Name:VASCULAR SPECIALTY ASSOCIATES
Entity Type:Organization
Organization Name:VASCULAR SPECIALTY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:LABAUVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-769-4493
Mailing Address - Street 1:8595 PICARDY AVE
Mailing Address - Street 2:STE 320
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-769-4493
Mailing Address - Fax:225-757-9609
Practice Address - Street 1:8595 PICARDY AVE
Practice Address - Street 2:STE 320
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-769-4493
Practice Address - Fax:225-757-9609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1795445Medicaid
LA5D250Medicare PIN