| Charlie Internal Medicine Group Incorporated | |
|
155 Hospital Dr Ste 205 Lafayette LA 70503-2852 | |
| (601) 549-1735 | |
| Not Available |
| Full Name | Charlie Internal Medicine Group Incorporated |
|---|---|
| Speciality | Internal Medicine |
| Location | 155 Hospital Dr Ste 205, Lafayette, Louisiana |
| Authorized Official Name and Position | Emily Reed Charlie (PRESIDENT) |
| Authorized Official Contact | 6015491735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charlie Internal Medicine Group Incorporated 716 Gendarme Rd Carencro LA 70520-5105 Ph: (601) 549-1735 | Charlie Internal Medicine Group Incorporated 155 Hospital Dr Ste 205 Lafayette LA 70503-2852 Ph: (601) 549-1735 |
| NPI Number | 1649837519 |
|---|---|
| Provider Enumeration Date | 05/24/2019 |
| Last Update Date | 05/24/2019 |
| Medicare PECOS PAC ID | 6507191541 |
|---|---|
| Medicare Enrollment ID | O20190712000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649837519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Emily R Charlie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295196194 PECOS PAC ID: 0042518516 Enrollment ID: I20190712000467 |
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