Provider Demographics
NPI:1912010380
Name:SAADAT, LYNDALL (MD)
Entity Type:Individual
Prefix:
First Name:LYNDALL
Middle Name:
Last Name:SAADAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7366
Mailing Address - Country:US
Mailing Address - Phone:318-812-0168
Mailing Address - Fax:318-812-0170
Practice Address - Street 1:102 THOMAS RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7366
Practice Address - Country:US
Practice Address - Phone:318-812-0168
Practice Address - Fax:318-812-0170
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020175208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1930695Medicaid
LAF01587Medicare UPIN
LA1930695Medicaid