| Clinton A Netherland, Md | |
|
510 S Washington St Bastrop LA 71220-5033 | |
| (318) 556-3333 | |
| (318) 283-5141 |
| Full Name | Clinton A Netherland, Md |
|---|---|
| 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 |
|---|---|
| Clinton A Netherland, Md 510 S Washington St Bastrop LA 71220-5033 Ph: (318) 556-3333 | Clinton A Netherland, Md 510 S Washington St Bastrop LA 71220-5033 Ph: (318) 556-3333 |
| NPI Number | 1902089246 |
|---|---|
| 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 |
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