Provider Demographics
NPI:1861106569
Name:THE RAJAPHO COMPANY LLC
Entity type:Organization
Organization Name:THE RAJAPHO COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRASITH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJAPHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-349-1525
Mailing Address - Street 1:404 BLUEBONNET DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6956
Mailing Address - Country:US
Mailing Address - Phone:337-349-1525
Mailing Address - Fax:
Practice Address - Street 1:4811 AMBASSADOR CAFFERY PKWY FL 4
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7265
Practice Address - Country:US
Practice Address - Phone:337-349-1525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty