BREAST CENTER OF ACADIANA, A PROFESSIONAL MEDICAL CORPORATION (NPI# 1366439549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366439549 |
| Entity Type | Organization |
| Organization Name | BREAST CENTER OF ACADIANA, A PROFESSIONAL MEDICAL CORPORATION |
| Practice Address |
935 Camellia Blvd Ste 100 Lafayette LA 70508-6961 |
| Mailing Address |
935 Camellia Blvd. Ste 100 Lafayette LA 70508 |
| Practice Telephone | 3375045000 |
| Practice Fax Number | 3375045646 |
| Mailing Telephone | 3374567479 |
| Mailing Fax Number | 3375045646 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | DR. GARY L. MATHEWS (OWNER/MD) |
| Authorized Official Telephone | 3375045000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1440744 | 05 |
| Street Address |
935 CAMELLIA BLVD STE 100 |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-6961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825371 | Jason R Comeaux | Physician Assistant | 935 Camellia Blvd, Ste 103, Lafayette, LA 70508-7084 | 2005-07-19 |
| 1831443571 | Heart and Vascular Associates of Acadiana, PC | Internal Medicine | 935 Camellia Blvd, Suite 103, Lafayette, LA 70508-7084 | 2012-11-02 |
| 1447542360 | Kevin Courville, M.d. | Internal Medicine | 935 Camellia Blvd, Suite 103, Lafayette, LA 70508-7084 | 2011-05-11 |
| 1093784761 | Advanced Imaging of Lafayette LLC | Clinic/Center | 935 Camellia Blvd, Suite 101, Lafayette, LA 70508-7084 | 2006-03-15 |
| 1386631463 | David J Jewell | Radiology | 935 Camellia Blvd, Suite 101, Lafayette, LA 70508-7084 | 2005-10-04 |
| 1598752875 | Gary L. Mathews | Radiology | 935 Camellia Blvd, Ste 100, Lafayette, LA 70508-6961 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588295448 | Hassan Sawaf | Radiology | 1411 S Creasy Ln Ste 130, Lafayette, IN 47905-7433 | 2020-01-30 |
| 1801383245 | St Marys Imaging Center II | Radiology | 4809 Ambassador Caffery Pkwy Ste 350, Lafayette, LA 70508-8801 | 2018-04-20 |
| 1578937744 | Modesto Radiological Medical Group | Radiology | 2283 Hidden Pond Ln, Lafayette, CA 94549-1742 | 2015-11-25 |
| 1629411210 | Lowell David Froker | Radiology | 32 Olympic Oaks Dr, Lafayette, CA 94549-4800 | 2013-04-12 |
| 1386987196 | Imaging Partners Medical Group | Radiology | 3976 Canyon Rd, Lafayette, CA 94549-2702 | 2013-03-29 |
| 1982946562 | Rachael Lane Guillory | Radiology | 1811 Dulles Dr, Lafayette, LA 70506-3724 | 2013-03-21 |
| 1578811386 | Maurice Louis Bercier | Radiology | 309 Steiner Road, Lafayette, LA 70508 | 2012-08-28 |
| 1295024222 | Lourdes Imaging Center LLC | Radiology | 4809 Ambassador Caffery Parkway, Suite 350, Lafayette, LA 70508 | 2011-03-30 |
| 1467784744 | Delano Zeus Arvin | Radiology | 6233 N 700 E, Lafayette, IN 47905-9761 | 2010-02-11 |
| 1003045287 | Professional Radiology Network Tlc-prn, LLC | Radiology | 107 Kempton Dr, Lafayette, LA 70508-6547 | 2009-07-08 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.