Provider Demographics
NPI:1285958926
Name:ATCHAFALAYA GYNECOLOOGY AND OBSTETRICS
Entity type:Organization
Organization Name:ATCHAFALAYA GYNECOLOOGY AND OBSTETRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATCHEZ
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORICE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:982-702-2229
Mailing Address - Street 1:1216 N VICTOR II BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1326
Mailing Address - Country:US
Mailing Address - Phone:985-702-2229
Mailing Address - Fax:985-384-0329
Practice Address - Street 1:1216 N VICTOR II BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1326
Practice Address - Country:US
Practice Address - Phone:985-702-2229
Practice Address - Fax:985-384-0329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14920R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty