| Organization Name: | SOUTH LOUISIANA SURGICAL ASSOCIATION, LLC |
| NPI Number: | 1023148855 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWARD W DAUTERIVE (M.D.) |
| Mailing Address: | 1100 Andre St Ste 101 New Iberia |
| State: | LA US |
| Postal Code: | 705632159 |
| Phone Number: | 3373699309 |
| Fax Number: | 3373658455 |
| NPI Enumeration Date: | 03/07/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |