Provider Demographics
NPI:1386806040
Name:ACADIAN MEDICAL CLINIC
Entity type:Organization
Organization Name:ACADIAN MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:DIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-338-1145
Mailing Address - Street 1:412 N ACADIAN THRUWAY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-3260
Mailing Address - Country:US
Mailing Address - Phone:225-338-1145
Mailing Address - Fax:225-338-1147
Practice Address - Street 1:412 N ACADIAN THRUWAY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3260
Practice Address - Country:US
Practice Address - Phone:225-338-1145
Practice Address - Fax:225-338-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD06213R261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1440493Medicaid