Provider Demographics
NPI:1881735595
Name:BANIEWICZ, FRANK J JR (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:BANIEWICZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FRANCIS
Other - Middle Name:J
Other - Last Name:BANIEWICZ
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:600 ROBERT LEE CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3139
Mailing Address - Country:US
Mailing Address - Phone:337-234-9681
Mailing Address - Fax:
Practice Address - Street 1:2501 W PINHOOK RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3346
Practice Address - Country:US
Practice Address - Phone:337-269-0136
Practice Address - Fax:337-233-8525
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD2010982083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine