| Alice Robert, Llc | |
|
106 S Lincoln St Tallulah LA 71282-4546 | |
| (504) 782-7848 | |
| (318) 574-3900 |
| Full Name | Alice Robert, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 106 S Lincoln St, Tallulah, Louisiana |
| Authorized Official Name and Position | Kelli D. Beavers (CREDENTIALING MANAGER) |
| Authorized Official Contact | 3183256200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alice Robert, Llc 106 S Lincoln St Tallulah LA 71282-4546 Ph: (504) 782-7848 | Alice Robert, Llc 106 S Lincoln St Tallulah LA 71282-4546 Ph: (504) 782-7848 |
| NPI Number | 1740548361 |
|---|---|
| Provider Enumeration Date | 05/02/2012 |
| Last Update Date | 05/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740548361 | NPI | - | NPPES |
| 1042935 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD.025610 (Louisiana) | Primary |
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