Provider Demographics
NPI:1487974044
Name:LAFAYETTE HEALTH VENTURES INC
Entity type:Organization
Organization Name:LAFAYETTE HEALTH VENTURES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-289-8969
Mailing Address - Street 1:PO BOX 53092
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-3092
Mailing Address - Country:US
Mailing Address - Phone:337-706-1533
Mailing Address - Fax:337-769-7164
Practice Address - Street 1:155 HOSPITAL DR STE 102
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2852
Practice Address - Country:US
Practice Address - Phone:337-289-8067
Practice Address - Fax:337-289-8066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAFAYETTE HEALTH VENTURES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2029542085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty