| Organization Name: | ADVANCED MEDICAL SERVICES OF LOUISIANA LLC |
| NPI Number: | 1083984363 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PERRY W ANTOINE (MANAGER) |
| Mailing Address: | 1417 Center St New Iberia |
| State: | LA US |
| Postal Code: | 705606112 |
| Phone Number: | 3375195323 |
| Fax Number: | |
| NPI Enumeration Date: | 01/04/2012 |
| NPI Last Update Date: | 01/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |