| Emergency Medicine Physician | |
|
211 4th St Alexandria LA 71301-8421 | |
| (318) 769-5002 | |
| Not Available |
| Full Name | Emergency Medicine Physician |
|---|---|
| Speciality | Family Medicine |
| Location | 211 4th St, Alexandria, Louisiana |
| Authorized Official Name and Position | Cary Randall Bybee (EMERGENCY MEDICINE PHYSICIAN) |
| Authorized Official Contact | 4042268839 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emergency Medicine Physician 428 Ansley Blvd Apt E Alexandria LA 71303-2286 Ph: (404) 226-8839 | Emergency Medicine Physician 211 4th St Alexandria LA 71301-8421 Ph: (318) 769-5002 |
| NPI Number | 1578091682 |
|---|---|
| Provider Enumeration Date | 06/02/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578091682 | NPI | - | NPPES |
| 1265852586 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD60676012 (Washington) | Primary |
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