Provider Demographics
NPI:1740596410
Name:GASTROENTEROLOGY SPECIALISTS OF ACADIANA, LLC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY SPECIALISTS OF ACADIANA, LLC
Other - Org Name:ALAN J. SONSKY, MD, APMC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SONSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-948-7040
Mailing Address - Street 1:3975 I 49 S SERVICE RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-0775
Mailing Address - Country:US
Mailing Address - Phone:337-948-7040
Mailing Address - Fax:337-948-7041
Practice Address - Street 1:3975 I 49 S SERVICE RD
Practice Address - Street 2:SUITE 230
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-0775
Practice Address - Country:US
Practice Address - Phone:337-948-7040
Practice Address - Fax:337-948-7041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.201243207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1009059Medicaid
LA4K520CX97Medicare PIN
LA1009059Medicaid