Provider Demographics
NPI:1700021961
Name:NOELL, KARL THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:THOMAS
Last Name:NOELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 GREENBRIAR RD.
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3408
Mailing Address - Country:US
Mailing Address - Phone:337-989-0630
Mailing Address - Fax:337-988-0343
Practice Address - Street 1:630 GREENBRIAR RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3408
Practice Address - Country:US
Practice Address - Phone:337-989-0630
Practice Address - Fax:337-988-0343
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06122R2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B90900Medicare UPIN