Freddie Fandal (NPI# 1538128285, PAC ID# 7517931454) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1538128285 |
| PAC ID by PECOS | 7517931454 |
| Professional Enrollment ID | I20050309000079 |
| Full Name | Freddie Fandal |
| Address |
17695 Hwy 190 Port Barre LA 70577-0001 |
| Phone Number | 3375857898 |
| Gender | M |
| Credential | MD |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT |
| Graduation Year | 1997 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 190017 | OPELOUSAS GENERAL HEALTH SYSTEM |
| Address | Phone | Organization |
|---|---|---|
| 17695 Hwy 190, Port Barre, LA 70577-0001 | 3375857898 |
| Street Address |
17695 HWY 190 |
| City | PORT BARRE |
| State | LA |
| Zip | 70577-0001 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eliza M Tate | Family Medicine | 17695 Hwy 190, Port Barre, LA 70577-5178 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda Zazeski | Occupational Therapy | Alvin C Moreau Jr Licensed | 16309 Hwy 190, Port Barre, LA 70577-5115 |
| Alvin C Moreau Iii | Physical Therapy | Alvin C Moreau Jr Licensed | 16309 Hwy 190, Port Barre, LA 70577-5115 |
| Rhonda Gerace Bergeron | Nurse Practitioner | Acadiana Practitioners LLC | 414 Saizan Ave, Port Barre, LA 70577-5156 |
| Jennifer Ewing Marchand | Nurse Practitioner | Acadiana Practitioners LLC | 414 Saizan Ave, Port Barre, LA 70577-5156 |
| City | PORT BARRE |
| Zip Code | 70577 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PORT BARRE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Freddie Fandal.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.