Vidrine, Calvin Dale
Vidrine, Calvin Dale is an sole proprietor health care provider with primary practice located at 174 Grant Rd , Opelousas LA 70570-0720. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Vidrine, Calvin Dale can be contacted via phone (337) 594-9637.Contact Information
Primary practice address
174 Grant Rd
Opelousas LA 70570-0720
Phone: (337) 594-9637
Fax: (337) 948-4556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 10041005 | Louisiana |
Profile Details
| NPI number | 1639122195 |
|---|---|
| LBN Legal business name | Vidrine, Calvin Dale |
| Credentials | CRA RJ RN |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2006 |
| Last updated | Feb 29th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639122195 | NPPES |
| Louisiana | MEDICAID | 1664669 | |
| Louisiana | Other | 2000777340 |
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