Provider Demographics
NPI:1659820777
Name:RADIATION ONCOLOGY ASSOCIATES OF ACADIANA, LLP
Entity Type:Organization
Organization Name:RADIATION ONCOLOGY ASSOCIATES OF ACADIANA, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-769-8660
Mailing Address - Street 1:4809 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8800
Mailing Address - Country:US
Mailing Address - Phone:337-769-8660
Mailing Address - Fax:337-769-8661
Practice Address - Street 1:4809 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8800
Practice Address - Country:US
Practice Address - Phone:337-769-8660
Practice Address - Fax:337-769-8661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty