Carlockenterprises Llc | |
2778 Hwy 121 Suite A Otis LA 71466-0000 | |
(318) 793-5020 | |
Not Available |
Full Name | Carlockenterprises Llc |
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Speciality | Clinic/Center |
Location | 2778 Hwy 121, Otis, Louisiana |
Authorized Official Name and Position | Victor Carlock (FNP/OWNER) |
Authorized Official Contact | 3184195188 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Carlockenterprises Llc 2778 Hwy 121 Suite A Otis LA 71466-0000 Ph: (318) 793-5020 | Carlockenterprises Llc 2778 Hwy 121 Suite A Otis LA 71466-0000 Ph: (318) 793-5020 |
NPI Number | 1437506474 |
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Provider Enumeration Date | 05/19/2016 |
Last Update Date | 02/02/2021 |
Medicare PECOS PAC ID | 3476707514 |
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Medicare Enrollment ID | O20180925002091 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437506474 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |