1003990656 NPI number — FERNANDO ALEMANY M.D.,

Table of content: FERNANDO ALEMANY M.D., (NPI 1003990656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003990656 NPI number — FERNANDO ALEMANY M.D.,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEMANY
Provider First Name:
FERNANDO
Provider Middle Name:
Provider Name Prefix Text:
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:
1003990656
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3975 I-49 S SERVICES RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
OPELOUSAS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70570-0758
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-594-0750
Provider Business Mailing Address Fax Number:
337-594-0752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3975 I-49 S SERVICES RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
OPELOUSAS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70570-0758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-594-0750
Provider Business Practice Location Address Fax Number:
337-594-0752
Provider Enumeration Date:
10/24/2006

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: 207R00000X , with the licence number:  024087 , 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: 1574635 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024087 . This is a "LICENSE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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