Provider Demographics
NPI:1932421682
Name:PATRICK S. SAVOY, M.D., A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:PATRICK S. SAVOY, M.D., A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAVOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-335-0303
Mailing Address - Street 1:142 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-3035
Mailing Address - Country:US
Mailing Address - Phone:318-335-0303
Mailing Address - Fax:318-335-3033
Practice Address - Street 1:142 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-3035
Practice Address - Country:US
Practice Address - Phone:318-335-0303
Practice Address - Fax:318-335-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.10065R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5U006Medicare PIN