| Jefferson Medical Clinic Llc | |
|
435 Lapalco Blvd Ste 1 Gretna LA 70056-7375 | |
| (504) 392-4114 | |
| (504) 533-8622 |
| Full Name | Jefferson Medical Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 435 Lapalco Blvd Ste 1, Gretna, Louisiana |
| Authorized Official Name and Position | Son Binh Nguyen (MANAGING MEMBER) |
| Authorized Official Contact | 5043924114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Medical Clinic Llc 435 Lapalco Blvd Gretna LA 70056-7369 Ph: (504) 392-4114 | Jefferson Medical Clinic Llc 435 Lapalco Blvd Ste 1 Gretna LA 70056-7375 Ph: (504) 392-4114 |
| NPI Number | 1952747602 |
|---|---|
| Provider Enumeration Date | 05/21/2013 |
| Last Update Date | 12/17/2019 |
| Medicare PECOS PAC ID | 7214165703 |
|---|---|
| Medicare Enrollment ID | O20140108000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952747602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Bernard A Landry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871584714 PECOS PAC ID: 4789571191 Enrollment ID: I20040920000100 |
| Provider Name | William Kenneth Mask |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215030507 PECOS PAC ID: 2264452457 Enrollment ID: I20080722000445 |
| Provider Name | Frank Voelker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316928260 PECOS PAC ID: 7214026665 Enrollment ID: I20101021000572 |
| Provider Name | Son B Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710121348 PECOS PAC ID: 1254588072 Enrollment ID: I20120830000368 |
| Provider Name | Ngoc-thuy Bui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306080361 PECOS PAC ID: 9638320393 Enrollment ID: I20121107000095 |
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