Provider Demographics
NPI:1679677173
Name:LOUISIANA ONCOLOGY ASSOCIATES, PMC
Entity type:Organization
Organization Name:LOUISIANA ONCOLOGY ASSOCIATES, PMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-235-7898
Mailing Address - Street 1:4809 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:STE 110
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8800
Mailing Address - Country:US
Mailing Address - Phone:337-235-7898
Mailing Address - Fax:337-235-7445
Practice Address - Street 1:4809 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:STE 110
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8800
Practice Address - Country:US
Practice Address - Phone:337-235-7898
Practice Address - Fax:337-235-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1940372Medicaid
LACS3008OtherRR MEDICARE
LA57690Medicare ID - Type Unspecified