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176 Washington St Golden Meadow LA 70357-2938 | |
(985) 475-5200 | |
(985) 475-5664 |
Full Name | |
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Speciality | Family Medicine |
Location | 176 Washington St, Golden Meadow, Louisiana |
Authorized Official Name and Position | Tad A. Lafont (DIRECTOR OF PRACTICE MANAGEMENT) |
Authorized Official Contact | 9853259300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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176 Washington St Golden Meadow LA 70357-2938 Ph: (985) 475-5200 | 176 Washington St Golden Meadow LA 70357-2938 Ph: (985) 475-5200 |
NPI Number | 1376590430 |
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Provider Enumeration Date | 05/27/2006 |
Last Update Date | 01/11/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376590430 | NPI | - | NPPES |
1459259 | Medicaid | LA | |
5CH34 | Other | LA | MEDICARE PART B |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |