| Carlock Family Medical Clinic | |
|
1100 Nolan Trace Leesville LA 71446 | |
| (337) 238-5180 | |
| (337) 238-4840 |
| Full Name | Carlock Family Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1100 Nolan Trace, Leesville, Louisiana |
| Authorized Official Name and Position | Victor Vance Carlock (PROVIDER / OWNER) |
| Authorized Official Contact | 3372385180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlock Family Medical Clinic 1100 Nolan Trace Leesville LA 71446 Ph: (337) 238-5180 | Carlock Family Medical Clinic 1100 Nolan Trace Leesville LA 71446 Ph: (337) 238-5180 |
| NPI Number | 1649524257 |
|---|---|
| Provider Enumeration Date | 11/05/2012 |
| Last Update Date | 04/16/2018 |
| Medicare PECOS PAC ID | 3476707514 |
|---|---|
| Medicare Enrollment ID | O20130125000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649524257 | NPI | - | NPPES |
| Provider Name | Jennifer B Carlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164616553 PECOS PAC ID: 5890883938 Enrollment ID: I20071126000709 |
| Provider Name | Victor Carlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396948402 PECOS PAC ID: 9335237478 Enrollment ID: I20110829000086 |
| Provider Name | Robert K. Lamme |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548422181 PECOS PAC ID: 6406038025 Enrollment ID: I20120724000200 |
| Provider Name | Robyn Briscoe Dowdle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871046128 PECOS PAC ID: 8022395003 Enrollment ID: I20170428001181 |
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