Provider Demographics
NPI:1972607505
Name:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, ALEXANDRIA,LA
Entity type:Organization
Organization Name:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, ALEXANDRIA,LA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF PHYSICAL MEDICINE AND REHA
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDOUS
Authorized Official - Middle Name:ARA
Authorized Official - Last Name:CHOUDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-473-0010
Mailing Address - Street 1:6424 MOODY OAKS
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-2776
Mailing Address - Country:US
Mailing Address - Phone:318-445-8202
Mailing Address - Fax:318-483-5060
Practice Address - Street 1:2495 SHREVEPORT HWY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4044
Practice Address - Country:US
Practice Address - Phone:318-473-0010
Practice Address - Fax:318-483-5060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163958282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital