Provider Demographics
NPI:1811910862
Name:GONZALEZ-ROMAN, ARTURO DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:DAVID
Last Name:GONZALEZ-ROMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 W CONGRESS ST
Mailing Address - Street 2:UNIVERSITY HOSPITAL & CLINICS, INTERVENTIONAL RADIOLOGY
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4205
Mailing Address - Country:US
Mailing Address - Phone:337-261-6000
Mailing Address - Fax:337-261-6153
Practice Address - Street 1:DEPARTMENT OF RADIOLOGY
Practice Address - Street 2:1542 TULANE AVE, BOX T2-2
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112
Practice Address - Country:US
Practice Address - Phone:504-568-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.13104R2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1429210Medicaid
LA1429210Medicaid
5H833Medicare ID - Type Unspecified