| Indira Gautam Md A Professional Medical Corporation | |
|
327 Iberia St Suite 3a Youngsville LA 70592-6370 | |
| (337) 857-3512 | |
| Not Available |
| Full Name | Indira Gautam Md A Professional Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 327 Iberia St, Youngsville, Louisiana |
| Authorized Official Name and Position | Indira Gautam (OWNER) |
| Authorized Official Contact | 3378573512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indira Gautam Md A Professional Medical Corporation 327 Iberia St Suite 3a Youngsville LA 70592-6370 Ph: (337) 857-3512 | Indira Gautam Md A Professional Medical Corporation 327 Iberia St Suite 3a Youngsville LA 70592-6370 Ph: (337) 857-3512 |
| NPI Number | 1235531989 |
|---|---|
| Provider Enumeration Date | 09/24/2014 |
| Last Update Date | 09/24/2014 |
| Medicare PECOS PAC ID | 5991925364 |
|---|---|
| Medicare Enrollment ID | O20141007000925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235531989 | NPI | - | NPPES |
| 1191167 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 15134R (Louisiana) | Primary |
| Provider Name | Indira Gautam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043283005 PECOS PAC ID: 5597655365 Enrollment ID: I20110210000148 |
Edward Lafleur Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2445 E Milton Ave, Youngsville, LA 70592 Phone: 337-856-6333 Fax: 337-856-6388 | |
Medxcel Occupational Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4401 Chemin Metaire Pkwy, Youngsville, LA 70592 Phone: 337-893-0788 Fax: 337-893-0787 | |
Youngsville Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3215 E Milton Ave, Suite 8, Youngsville, LA 70592 Phone: 337-857-6657 Fax: 337-857-6658 | |
Granger Eye Studio Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 Centre Sarcelle Blvd., Suite 704, Youngsville, LA 70592 Phone: 337-451-4511 Fax: 337-857-6044 | |
Edward Lafleur Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2445 E Milton Ave, Youngsville, LA 70592 Phone: 337-856-6333 Fax: 337-856-6388 | |
Kathryn Strother Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2445 E Milton Ave, Youngsville, LA 70592 Phone: 337-856-6333 Fax: 337-856-6388 |