| Julio E. Iglesias,m.d. A Professional Medical Corp | |
|
301 W Boundary Ave Suite A Winnfield LA 71483-3427 | |
| (318) 628-2108 | |
| (318) 628-6211 |
| Full Name | Julio E. Iglesias,m.d. A Professional Medical Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 W Boundary Ave, Winnfield, Louisiana |
| Authorized Official Name and Position | Julio E Iglesias (PRESIDENT/M.D.) |
| Authorized Official Contact | 3186282108 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Julio E. Iglesias,m.d. A Professional Medical Corp 301 W Boundary Ave Suite A Winnfield LA 71483-3427 Ph: (318) 628-2108 | Julio E. Iglesias,m.d. A Professional Medical Corp 301 W Boundary Ave Suite A Winnfield LA 71483-3427 Ph: (318) 628-2108 |
| NPI Number | 1255503082 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 01/05/2010 |
| Medicare PECOS PAC ID | 7810952884 |
|---|---|
| Medicare Enrollment ID | O20080501000505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255503082 | NPI | - | NPPES |
| 1205213510 | Other | LA | BLUE CROSS OF LOUISIANA |
| 02000158 | Other | GA | MC UNITED HEALTHCARE |
| 1317519 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 05638R (Louisiana) | Primary |
| Provider Name | Julio E Iglesias |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780663476 PECOS PAC ID: 4981501053 Enrollment ID: I20031217000097 |
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