Provider Demographics
NPI:1891953717
Name:GASTROENTEROLOGY CENTER OF LOUISIANA, INC.
Entity Type:Organization
Organization Name:GASTROENTEROLOGY CENTER OF LOUISIANA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-574-8001
Mailing Address - Street 1:4212 W CONGRESS ST
Mailing Address - Street 2:SUITE 2400E
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6765
Mailing Address - Country:US
Mailing Address - Phone:615-574-8001
Mailing Address - Fax:866-566-3203
Practice Address - Street 1:4212 W CONGRESS ST
Practice Address - Street 2:SUITE 2400E
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6765
Practice Address - Country:US
Practice Address - Phone:615-574-8001
Practice Address - Fax:866-566-3203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty