Provider Demographics
NPI:1710195144
Name:SADEGHI, SEYED ALIREZA (MD)
Entity Type:Individual
Prefix:DR
First Name:SEYED ALIREZA
Middle Name:
Last Name:SADEGHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:SADEGHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:104 ALBERTSON PKWY STE 6
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-5325
Mailing Address - Country:US
Mailing Address - Phone:337-330-2339
Mailing Address - Fax:337-330-2352
Practice Address - Street 1:753 ODD FELLOWS RD STE F
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2200
Practice Address - Country:US
Practice Address - Phone:337-514-5233
Practice Address - Fax:337-514-5235
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAM.D.203025207Q00000X
CA180617207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine