Provider Demographics
NPI:1679896732
Name:BARIATRIC & ADVANCED SURGICAL
Entity Type:Organization
Organization Name:BARIATRIC & ADVANCED SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:VIGLAINCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-446-2524
Mailing Address - Street 1:604 N ACADIA RD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4897
Mailing Address - Country:US
Mailing Address - Phone:985-446-2524
Mailing Address - Fax:985-447-2329
Practice Address - Street 1:604 N ACADIA RD
Practice Address - Street 2:SUITE 406
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4897
Practice Address - Country:US
Practice Address - Phone:985-446-2524
Practice Address - Fax:985-447-2329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.203566208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty