Provider Demographics
NPI:1861453201
Name:ACADIANA OTOLARYNGOLOGY HEAD AND NECK SURGERY LLC
Entity type:Organization
Organization Name:ACADIANA OTOLARYNGOLOGY HEAD AND NECK SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-981-6464
Mailing Address - Street 1:PO BOX 52068
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-2068
Mailing Address - Country:US
Mailing Address - Phone:337-981-6464
Mailing Address - Fax:337-981-6440
Practice Address - Street 1:4212 W CONGRESS ST STE 1500
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6767
Practice Address - Country:US
Practice Address - Phone:337-981-6464
Practice Address - Fax:337-981-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1945960Medicaid
5F652Medicare ID - Type Unspecified