Provider Demographics
NPI:1134779101
Name:SIDE-BY-SIDE MEDICAL SERVICES A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SIDE-BY-SIDE MEDICAL SERVICES A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-508-0057
Mailing Address - Street 1:304 E VETERANS MEML DR
Mailing Address - Street 2:
Mailing Address - City:KAPLAN
Mailing Address - State:LA
Mailing Address - Zip Code:70548-5009
Mailing Address - Country:US
Mailing Address - Phone:337-643-8424
Mailing Address - Fax:337-643-8407
Practice Address - Street 1:304 E VETERANS MEML DR
Practice Address - Street 2:
Practice Address - City:KAPLAN
Practice Address - State:LA
Practice Address - Zip Code:70548-5009
Practice Address - Country:US
Practice Address - Phone:337-643-8424
Practice Address - Fax:337-643-8407
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM ALDEN MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-12
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAMD.024150OtherMEDICAL LICENSE