1407877350 NPI number — DR. ANDREW R, HARWOOD M.D.

Table of content: NGAN DINH (NPI 1770065393)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407877350 NPI number — DR. ANDREW R, HARWOOD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARWOOD
Provider First Name:
ANDREW
Provider Middle Name:
R,
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407877350
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4809 AMBASSADOR CAFFERY PKWY
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70508-8800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-769-8660
Provider Business Mailing Address Fax Number:
337-769-8661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4809 AMBASSADOR CAFFERY PKWY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70508-8800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-769-8660
Provider Business Practice Location Address Fax Number:
337-769-8661
Provider Enumeration Date:
07/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  06638R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1348007 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06638R . This is a "STATE MEDICAL LICENSE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 5DX68 . This is a "ONCOLOGICS LLC PTAN GROUP" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 5M543DD21 . This is a "PTAN 3 OF 3: EFF 04-28-08" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 5M543DX68 . This is a "ANDREW HARWOOD MEDICARE PTAN EFFECTIVE 05/19/2012" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 5M543DX68 . This is a "PTAN 1 OF 3: EFF 04-30-12" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 5M543C895 . This is a "PTAN 2 OF 3: EFF 01-19-04" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com