| Tawfik Benghozi A Professional Medical Corporation | |
|
5920 Coliseum Blvd Alexandria LA 71303-3714 | |
| (318) 443-9339 | |
| (318) 443-9116 |
| Full Name | Tawfik Benghozi A Professional Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5920 Coliseum Blvd, Alexandria, Louisiana |
| Authorized Official Name and Position | Debbie Walters (OFFICE MANAGER) |
| Authorized Official Contact | 3184439339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tawfik Benghozi A Professional Medical Corporation 5920 Coliseum Blvd Alexandria LA 71303-3714 Ph: (318) 443-9339 | Tawfik Benghozi A Professional Medical Corporation 5920 Coliseum Blvd Alexandria LA 71303-3714 Ph: (318) 443-9339 |
| NPI Number | 1275921272 |
|---|---|
| Provider Enumeration Date | 12/30/2014 |
| Last Update Date | 12/30/2014 |
| Medicare PECOS PAC ID | 8426377581 |
|---|---|
| Medicare Enrollment ID | O20150512001879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275921272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Tawfik M Mukhtar-benghozi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790774081 PECOS PAC ID: 0648288852 Enrollment ID: I20060330000128 |
| Provider Name | Christina Lynn Brister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487885034 PECOS PAC ID: 7517012248 Enrollment ID: I20090902000283 |
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