Provider Demographics
NPI:1922082262
Name:CARAWAY, JOSEPH R (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:R
Last Name:CARAWAY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 LORRAINE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4009
Mailing Address - Country:US
Mailing Address - Phone:337-474-3045
Mailing Address - Fax:
Practice Address - Street 1:2604 LORRAINE LN
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-4009
Practice Address - Country:US
Practice Address - Phone:337-474-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04394367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1179281Medicaid
TX8F21347Medicare PIN
LA1179281Medicaid