Provider Demographics
NPI:1780191890
Name:ACADIANA PEDIATRICS, L.L.C.
Entity Type:Organization
Organization Name:ACADIANA PEDIATRICS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-334-7554
Mailing Address - Street 1:717 CURTIS DR STE A
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-8311
Mailing Address - Country:US
Mailing Address - Phone:337-334-7554
Mailing Address - Fax:337-334-7556
Practice Address - Street 1:717 CURTIS DR
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-8311
Practice Address - Country:US
Practice Address - Phone:337-334-7551
Practice Address - Fax:337-334-7556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health