Provider Demographics
NPI:1982063780
Name:ACADIANA PEDIATRIC GASTROENTEROLOGY AND HEPATOLOGY
Entity type:Organization
Organization Name:ACADIANA PEDIATRIC GASTROENTEROLOGY AND HEPATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JATINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BHARDWAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-889-3817
Mailing Address - Street 1:101 GUILBEAU RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6138
Mailing Address - Country:US
Mailing Address - Phone:337-889-3817
Mailing Address - Fax:
Practice Address - Street 1:101 GUILBEAU RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6138
Practice Address - Country:US
Practice Address - Phone:337-889-3817
Practice Address - Fax:337-889-3818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty