Provider Demographics
NPI:1841286200
Name:BENDEL MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:BENDEL MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-232-5864
Mailing Address - Street 1:227A BENDEL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2903
Mailing Address - Country:US
Mailing Address - Phone:337-232-5864
Mailing Address - Fax:337-234-6887
Practice Address - Street 1:227A BENDEL RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2903
Practice Address - Country:US
Practice Address - Phone:337-232-5864
Practice Address - Fax:337-234-6887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA=========0OtherBLUE CROSS PROVIDER NUMBR
LA57711Medicare PIN