Heinen Family Medicine | |
3845 Brookflower Circle Ln Lake Charles LA 70605-0292 | |
(337) 477-5988 | |
Not Available |
Full Name | Heinen Family Medicine |
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Speciality | Family Medicine |
Location | 3845 Brookflower Circle Ln, Lake Charles, Louisiana |
Authorized Official Name and Position | David P Heinen (OWNER) |
Authorized Official Contact | 3374775988 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Heinen Family Medicine Po Box 15 Lake Charles LA 70602-0015 Ph: (337) 477-5988 | Heinen Family Medicine 3845 Brookflower Circle Ln Lake Charles LA 70605-0292 Ph: (337) 477-5988 |
NPI Number | 1588622575 |
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Provider Enumeration Date | 05/02/2006 |
Last Update Date | 06/15/2023 |
Medicare PECOS PAC ID | 6901821081 |
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Medicare Enrollment ID | O20051007000351 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588622575 | NPI | - | NPPES |
4385507860 | Other | LA | BCBS |
1053368 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Provider Name | David P Heinen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1659388866 PECOS PAC ID: 9931133485 Enrollment ID: I20050923000260 |
Provider Name | Clay Lawrence Hill |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174956510 PECOS PAC ID: 3274758339 Enrollment ID: I20140702002465 |
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