ACADIANA SURGICAL CLINIC INC (NPI# 1821089665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821089665 |
| Entity Type | Organization |
| Organization Name | ACADIANA SURGICAL CLINIC INC |
| Practice Address |
3975 I 49 S Service Rd Suite 105 Opelousas LA 70570-0775 |
| Practice Telephone | 3379487680 |
| Practice Fax Number | 3379481143 |
| Mailing Telephone | 3379487680 |
| Mailing Fax Number | 3379481143 |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2011-11-09 |
| Authorized Official Name | DR. GLYNN A. GRANGER (OWNER/MD) |
| Authorized Official Telephone | 3379487680 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | RAILROAD MEDICARE | CN6611 | 01 |
| LA | 1457221 | 05 |
| Street Address |
3975 I 49 S SERVICE RD SUITE 105 |
| City | OPELOUSAS |
| State | LA |
| Zip Code | 70570-0775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063419745 | Jimmy Legros IIi | Nurse Practitioner | 3975 I 49 S Service Rd, 234, Opelousas, LA 70570-0775 | 2005-07-07 |
| 1255689600 | Opelousas General Health System Physician Practices | Pediatrics | 3975 I 49 S Service Rd, Suite 201, Opelousas, LA 70570-0775 | 2012-08-16 |
| 1528346251 | Supraja Yeturi | Internal Medicine | 3975 I 49 S Service Rd, Suite 200, Opelousas, LA 70570-0775 | 2011-07-29 |
| 1427341908 | Ships Medical, LLC | Orthopaedic Surgery | 3975 I 49 S Service Rd, Suite 103, Opelousas, LA 70570-0775 | 2011-05-17 |
| 1740596410 | Gastroenterology Specialists of Acadiana, LLC | Internal Medicine | 3975 I 49 S Service Rd, Suite 230, Opelousas, LA 70570-0775 | 2010-08-19 |
| 1275767063 | April Danielle Woodrow | Nurse Practitioner | 3975 I 49 S Service Rd, Suite 200, Opelousas, LA 70570-0775 | 2009-05-07 |
| 1780875740 | Chachere Provost Medicine, LLC | Obstetrics & Gynecology | 3975 I 49 S Service Rd, Suite 205a, Opelousas, LA 70570-0775 | 2007-08-06 |
| 1619014024 | Fernando Alemany Md Apmc | Internal Medicine | 3975 I 49 S Service Rd, Suite 200, Opelousas, LA 70570-0775 | 2007-02-01 |
| 1457305492 | Opelousas Pet Ct Imaging Center LLC | Clinic/Center | 3975 I 49 S Service Rd, Opelousas, LA 70570-0775 | 2006-05-22 |
| 1629069034 | Glynn Adam Granger | Surgery | 3975 I 49 S Service Rd, Suite 105, Opelousas, LA 70570-0775 | 2005-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821608282 | Dream Angels Agency | Home Health | 356 Country Ridge Rd., 21, Opelousas, LA 70570 | 2020-07-31 |
| 1588286389 | Kasey Dunn | Nurse Practitioner | 3983 Interstate-49 South Service Rd., Suite 103, Opelousas, LA 70570 | 2020-05-14 |
| 1538704010 | Southern Family Medicine, LLC | Nurse Practitioner | 10818 Hwy. 190, Opelousas, LA 70570 | 2019-11-08 |
| 1952952061 | Check Point Urgent Care | Clinic/Center | 2331 S Union Street, Opelousas, LA 70570 | 2019-09-20 |
| 1639734015 | Southern Pharmacy LLC | Pharmacy | 3939 I-49 South Service Rd., Opelousas, LA 70570 | 2019-05-01 |
| 1245708452 | Anthony Ray Parker Jr. | Case Manager/Care Coordinator | 208 Ballard Loop, Opelousas, LA 70570 | 2018-11-06 |
| 1306329511 | Katherine D Trahan | Pharmacy | 3935 I-49 South Service Rd, Opelousas, LA 70570 | 2018-09-13 |
| 1548752942 | Justin Y Auzenne | Driver | 230 Lemelle St, Opelousas, LA 70570 | 2018-05-31 |
| 1063920650 | Laykin Bellard | Nurse Practitioner | 3975 I-49 Frontage Rd, Suite 201, Opelousas, LA 70570 | 2018-01-17 |
| 1124535562 | Lisa M Miller | Counselor | 1211 Austin Rd, Opelousas, LA 70570 | 2018-01-08 |
| Find all providers in zip 70570 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467616037 | Nina Keith Hall Md Pmc | Surgery | 1825 Edwards St, Opelousas, LA 70570-4777 | 2008-07-14 |
| 1407883556 | Kerry T. Thibodeaux Md Apmc | Surgery | 1233 Wayne Gilmore Cirlce, Suite 205b, Opelousas, LA 70570 | 2006-06-26 |
| 1053317016 | Opelousas General Health System | Surgery | 703 E Prudhomme St, Suite 1, Opelousas, LA 70570-6494 | 2005-06-23 |
| 1003810979 | Toby D. Broussard, M.d., Apmc | Surgery | 1270 Attakapas Dr, Ste 101, Opelousas, LA 70570-6549 | 2005-06-09 |
| 1295098747 | Opelousas General Health System Physician Practices | Surgery | 539 E Prudhomme St, Opelousas, LA 70570-6499 | 2012-06-20 |
| 1013209329 | Mark Andrew Sicard | Surgery | 703 E Prudhomme St, Opelousas, LA 70570-6494 | 2011-05-04 |
| 1275794679 | Opelousas General Health System | Surgery | 703 E Prudhomme St, Suite 3, Opelousas, LA 70570-6494 | 2008-06-19 |
| 1255598223 | Opelousas General Health System | Surgery | 703 E Prudhomme St, Suite 2, Opelousas, LA 70570-6494 | 2008-05-19 |
| 1528278819 | Salvador H Vazquez | Surgery | 703 E Prudhomme St, Opelousas, LA 70570-6494 | 2007-05-23 |
| 1659428332 | Louis M Corne Jr Md LLC | Surgery | 703 E Prudhomme St, Opelousas, LA 70570-6494 | 2007-01-04 |
| Find all providers in OPELOUSAS | ||||
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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.