Provider Demographics
NPI:1053607770
Name:LOUISIANA IVF LLC
Entity type:Organization
Organization Name:LOUISIANA IVF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-989-8795
Mailing Address - Street 1:206 E FARREL RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7104
Mailing Address - Country:US
Mailing Address - Phone:337-989-8795
Mailing Address - Fax:337-989-8766
Practice Address - Street 1:206 E FARREL RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7104
Practice Address - Country:US
Practice Address - Phone:337-989-8795
Practice Address - Fax:337-989-8766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021643207VE0102X
LA000251207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty