| Family Medicine Clinic | |
|
2309 East Main Street Suite 400 New Iberia LA 70560 | |
| (337) 367-0271 | |
| (337) 364-6139 |
| Full Name | Family Medicine Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 2309 East Main Street, New Iberia, Louisiana |
| Authorized Official Name and Position | Jose A Mata (PARTNER) |
| Authorized Official Contact | 3373670271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Clinic 2309 East Main Street Suite 400 New Iberia LA 70560 Ph: (337) 367-0271 | Family Medicine Clinic 2309 East Main Street Suite 400 New Iberia LA 70560 Ph: (337) 367-0271 |
| NPI Number | 1114109923 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 03/11/2008 |
| Medicare PECOS PAC ID | 0446476956 |
|---|---|
| Medicare Enrollment ID | O20140718000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114109923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 015812 (Louisiana) | Primary |
| Provider Name | George B Cousin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275532186 PECOS PAC ID: 6709804651 Enrollment ID: I20051109000301 |
| Provider Name | Jose A Mata |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1962402859 PECOS PAC ID: 0244258192 Enrollment ID: I20051109000308 |
| Provider Name | Michelle L Menard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245439827 PECOS PAC ID: 4789867516 Enrollment ID: I20110331000529 |
| Provider Name | Ronald Tyler Hebert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003310897 PECOS PAC ID: 6507290020 Enrollment ID: I20191216002476 |
| Provider Name | Caitlin M Mcdaniel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902432842 PECOS PAC ID: 6204242365 Enrollment ID: I20220324000476 |
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