Provider Demographics
NPI:1891123402
Name:GASTROENTEROLOGY ASSOCIATES OF ACADIANA, LLC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES OF ACADIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ABSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-232-6697
Mailing Address - Street 1:1211 COOLIDGE BLVD
Mailing Address - Street 2:SUITE 303-B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2636
Mailing Address - Country:US
Mailing Address - Phone:337-534-8905
Mailing Address - Fax:337-534-8915
Practice Address - Street 1:1211 COOLIDGE BLVD
Practice Address - Street 2:SUITE 303-B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2636
Practice Address - Country:US
Practice Address - Phone:337-534-8905
Practice Address - Fax:337-534-8915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory