Provider Demographics
NPI:1972803278
Name:MEDICINE AVIATION & PETROLEUM LLC
Entity type:Organization
Organization Name:MEDICINE AVIATION & PETROLEUM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GALENO
Authorized Official - Middle Name:
Authorized Official - Last Name:SIBILIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:337-258-6368
Mailing Address - Street 1:305 LA VILLA CIR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5550
Mailing Address - Country:US
Mailing Address - Phone:337-258-6368
Mailing Address - Fax:337-857-5295
Practice Address - Street 1:301 A YOUNGSVILLE HWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-258-6368
Practice Address - Fax:337-857-5295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13399R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty