| |
510 S Washington St Bastrop LA 71220-5033 | |
(318) 556-3333 | |
(318) 283-5141 |
Full Name | |
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Speciality | Family Medicine |
Location | 510 S Washington St, Bastrop, Louisiana |
Authorized Official Name and Position | Clinton A Netherland (PRESIDENT) |
Authorized Official Contact | 3185563333 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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510 S Washington St Bastrop LA 71220-5033 Ph: (318) 556-3333 | 510 S Washington St Bastrop LA 71220-5033 Ph: (318) 556-3333 |
NPI Number | 1902089246 |
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Provider Enumeration Date | 12/10/2007 |
Last Update Date | 12/10/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902089246 | NPI | - | NPPES |
1104108 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Camilla Carter, Md & Carter Cox Jr., Md Apc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 South Vine Street, Bastrop, LA 71220 Phone: 318-281-3521 Fax: 318-281-3537 | |
Robert E Lyon Internal Medicine, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 Gunby Ave, Bastrop, LA 71220 Phone: 318-281-3432 Fax: 318-281-8850 | |