Provider Demographics
NPI:1871719823
Name:JOHN R. BUDDEN, M.D. APMC
Entity type:Organization
Organization Name:JOHN R. BUDDEN, M.D. APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROWLAND
Authorized Official - Last Name:BUDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-289-9212
Mailing Address - Street 1:1103 KALISTE SALOOM RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5783
Mailing Address - Country:US
Mailing Address - Phone:337-289-9212
Mailing Address - Fax:337-289-5964
Practice Address - Street 1:2625 NORTH DR
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4042
Practice Address - Country:US
Practice Address - Phone:337-289-9212
Practice Address - Fax:337-289-5964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.016582207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA435828255AOtherBLUE CROSS
LA1367362Medicaid
LA1861468910OtherINDIVIDUAL NPI NUMBER
LA435828255AOtherBLUE CROSS
LA1367362Medicaid