| |
450 E Pine Street Bastrop LA 71220-3840 | |
(318) 283-0868 | |
(318) 283-0875 |
Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 450 E Pine Street, Bastrop, Louisiana |
Authorized Official Name and Position | Octavia Green (ADMINISTRATIVE PROGRAM SPECIALIST B) |
Authorized Official Contact | 3183623270 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
450 E Pine Street Bastrop LA 71220-3840 Ph: (318) 283-0868 | 450 E Pine Street Bastrop LA 71220-3840 Ph: (318) 283-0868 |
NPI Number | 1225782196 |
---|---|
Provider Enumeration Date | 02/09/2022 |
Last Update Date | 08/30/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225782196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Camilla Carter, Md & Carter Cox Jr., Md Apc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 South Vine Street, Bastrop, LA 71220 Phone: 318-281-3521 Fax: 318-281-3537 | |
Robert E Lyon Internal Medicine, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 Gunby Ave, Bastrop, LA 71220 Phone: 318-281-3432 Fax: 318-281-8850 | |