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506 S 6th St Leesville LA 71446-4482 | |
(337) 239-0989 | |
(337) 392-9383 |
Full Name | |
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Speciality | Clinic/Center |
Location | 506 S 6th St, Leesville, Louisiana |
Authorized Official Name and Position | Donald E. Cameron (BOARD MEMBER) |
Authorized Official Contact | 3182268202 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1020 W Fertitta Blvd Leesville LA 71446-4645 Ph: (318) 239-9041 | 506 S 6th St Leesville LA 71446-4482 Ph: (337) 239-0989 |
NPI Number | 1871065516 |
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Provider Enumeration Date | 12/19/2018 |
Last Update Date | 03/16/2023 |
Medicare PECOS PAC ID | 4082963301 |
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Medicare Enrollment ID | O20190502000664 |
Identifier | Type | State | Issuer |
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1871065516 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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