| Acadiana Id Associates, Llc | |
|
1700 Kaliste Saloom Rd Bldg 6 Suite 600 Lafayette LA 70508-6112 | |
| (337) 534-4131 | |
| (337) 385-5859 |
| Full Name | Acadiana Id Associates, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1700 Kaliste Saloom Rd Bldg 6, Lafayette, Louisiana |
| Authorized Official Name and Position | Vitalis Okechukwu (OWNER) |
| Authorized Official Contact | 3375344131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acadiana Id Associates, Llc Po Box 81247 Lafayette LA 70598-1247 Ph: (337) 534-4131 | Acadiana Id Associates, Llc 1700 Kaliste Saloom Rd Bldg 6 Suite 600 Lafayette LA 70508-6112 Ph: (337) 534-4131 |
| NPI Number | 1063822997 |
|---|---|
| Provider Enumeration Date | 04/30/2014 |
| Last Update Date | 02/17/2021 |
| Medicare PECOS PAC ID | 7911123088 |
|---|---|
| Medicare Enrollment ID | O20140725000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063822997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 15601R (Louisiana) | Primary |
| Provider Name | Vitalis C Okechukwu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1659308211 PECOS PAC ID: 0244257806 Enrollment ID: I20051102000274 |
| Provider Name | Lindsi Pizzolato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720427966 PECOS PAC ID: 5294969952 Enrollment ID: I20131011000509 |
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