Provider Demographics
NPI:1427042175
Name:ROZAS, ALDES J III (MD)
Entity type:Individual
Prefix:
First Name:ALDES
Middle Name:J
Last Name:ROZAS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1344
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-1344
Mailing Address - Country:US
Mailing Address - Phone:337-824-7000
Mailing Address - Fax:337-824-1676
Practice Address - Street 1:1634 ELTON RD
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-3614
Practice Address - Country:US
Practice Address - Phone:337-616-7000
Practice Address - Fax:337-824-1171
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA0205182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1991007Medicaid
LA5N845Medicare ID - Type Unspecified
LA1991007Medicaid