PERIPHERAL VASCULAR, INC. (NPI# 1437183670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437183670 |
| Entity Type | Organization |
| Organization Name | PERIPHERAL VASCULAR, INC. |
| Other Organization Name | VASCULAB |
| Practice Address |
1100 Andre St Ste 101 New Iberia LA 70563-2159 |
| Practice Telephone | 3373699309 |
| Practice Fax Number | 3373658455 |
| Mailing Telephone | 3373699309 |
| Mailing Fax Number | 3373658455 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. EDWARD W DAUTERIVE JR. (DOCTOR) |
| Authorized Official Telephone | 3373699309 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1339334 | 05 |
| Other Name | Type Code |
|---|---|
| Vasculab | Other Name - Individual/Organization |
| Street Address |
1100 ANDRE ST STE 101 |
| City | NEW IBERIA |
| State | LA |
| Zip Code | 70563-2159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396088464 | Progressive Acute Care Physician Services, LLC | Surgery | 1100 Andre St Ste 101, New Iberia, LA 70563-2159 | 2013-03-27 |
| 1023148855 | South Louisiana Surgical Association, LLC | Clinic/Center | 1100 Andre St Ste 101, New Iberia, LA 70563-2159 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932696812 | Check Point Urgent Care | Clinic/Center | 1108 Parkview Drive Suite A, New Iberia, LA 70563 | 2018-04-17 |
| 1497285399 | Pamela Thibeaux | Counselor | 125 Duperier Ave, New Iberia, LA 70563 | 2017-06-14 |
| 1659662625 | Clyde Edward Landrum | Otolaryngology | 41 Shadows Bend, New Iberia, LA 70563 | 2011-04-26 |
| 1487956538 | Baker Suraj, Inc | Internal Medicine | 602 N. Lewis Ave., Suite 100, New Iberia, LA 70563 | 2010-11-23 |
| 1619174208 | Sleep Solutions of New Iberia, LLC | Clinic/Center | 1100 Andre St Ste 200b, New Iberia, LA 70563 | 2007-06-28 |
| 1134253768 | Mark Steve Derouen | Dentist | 2301 Old Jeanerette Road, New Iberia, LA 70563 | 2007-03-15 |
| 1851441927 | Nancy Ann Schneider | Nurse Practitioner | 1302 Ed Broussard Road, New Iberia, LA 70563 | 2007-01-11 |
| 1538245980 | Morgan & Associates | Durable Medical Equipment & Medical Supplies | 2213 Old Jeanerette Road, New Iberia, LA 70563 | 2006-10-28 |
| 1528143955 | Rebecca H Charpentier | Dentist | 600 Rue De Onetta, New Iberia, LA 70563 | 2006-10-26 |
| 1518054709 | Southern Rx | Pharmacy | 1033 Andre St, New Iberia, LA 70563 | 2006-10-07 |
| Find all providers in zip 70563 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124438247 | James Ernesto Murray | Radiology | 1514 Jefferson Hwy Fl 2, Jefferson, LA 70121-2429 | 2014-04-28 |
| 1023383486 | Dane Gallmann Mackey | Radiology | 880 Sherwood Forest Blvd, Baton Rouge, LA 70815-5262 | 2012-03-19 |
| 1922313865 | John William Eiser | Radiology | 205 Magnolia Dr, Metairie, LA 70005-4030 | 2010-08-16 |
| 1386888733 | Jeremy David Cannell | Radiology | 15790 Paul Vega Drive, Hammond, LA 70403 | 2009-04-29 |
| 1609012657 | Vascular Access Center of Southwest Louisiana LLC | Radiology | 1340 Surrey St, Suite 101, Lafayette, LA 70501-7618 | 2008-12-22 |
| 1457412983 | Charles N Aprill IIi | Radiology | 1919 Veterans Memorial Blvd Ste 101, Kenner, LA 70062-4003 | 2006-12-12 |
| 1891341400 | Amber Lynn Durel | Radiology | 2400 Canal St, New Orleans, LA 70119-6535 | 2019-08-11 |
| 1902258486 | Jphir LLC | Radiology | 10440 Hooper Rd, Baton Rouge, LA 70818-3203 | 2016-07-07 |
| 1619317500 | Ricky Miller | Radiology | 602 N Acadia Rd, Thibodaux, LA 70301-4823 | 2013-06-25 |
| 1518209394 | Laura Mirielle Leonards | Radiology | 15790 Paul Vega Md Dr, Hammond, LA 70403-1434 | 2013-03-20 |
| Find all providers with the same taxonomy | ||||
| City | NEW IBERIA |
| Zip Code | 70563 |
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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.