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1201 W Fertitta Blvd Leesville LA 71446-4637 | |
(337) 392-9438 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 1201 W Fertitta Blvd, Leesville, Louisiana |
Authorized Official Name and Position | Kevin James Quinn (CEO) |
Authorized Official Contact | 3372399041 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1201 W Fertitta Blvd Leesville LA 71446-4637 Ph: () - | 1201 W Fertitta Blvd Leesville LA 71446-4637 Ph: (337) 392-9438 |
NPI Number | 1194411694 |
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Provider Enumeration Date | 04/17/2023 |
Last Update Date | 12/16/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194411694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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