Provider Demographics
NPI:1780929604
Name:PARADIGM HEALTH SYSTEM
Entity type:Organization
Organization Name:PARADIGM HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:GRESSAFFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-882-4500
Mailing Address - Street 1:64301 HIGHWAY 434
Mailing Address - Street 2:
Mailing Address - City:LACOMBE
Mailing Address - State:LA
Mailing Address - Zip Code:70445-5411
Mailing Address - Country:US
Mailing Address - Phone:985-882-4500
Mailing Address - Fax:985-882-4501
Practice Address - Street 1:64301 HIGHWAY 434
Practice Address - Street 2:
Practice Address - City:LACOMBE
Practice Address - State:LA
Practice Address - Zip Code:70445-5411
Practice Address - Country:US
Practice Address - Phone:985-882-4500
Practice Address - Fax:985-882-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-04
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA94076534OtherOCCUPATIONAL BUSINESS LICENSE
6747710001OtherDME