| Lafayette Foundation Clinic Inc | |
|
121 Rue Louis Xiv Building 9, Suite A Lafayette LA 70508 | |
| (337) 988-9737 | |
| Not Available |
| Full Name | Lafayette Foundation Clinic Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 121 Rue Louis Xiv, Lafayette, Louisiana |
| Authorized Official Name and Position | Jason D Landry (MEDICAL DOCTOR) |
| Authorized Official Contact | 3379889737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lafayette Foundation Clinic Inc 121 Rue Louis Xiv Building 9, Suite A Lafayette LA 70508 Ph: (337) 988-9737 | Lafayette Foundation Clinic Inc 121 Rue Louis Xiv Building 9, Suite A Lafayette LA 70508 Ph: (337) 988-9737 |
| NPI Number | 1972144319 |
|---|---|
| Provider Enumeration Date | 10/07/2019 |
| Last Update Date | 05/14/2020 |
| Medicare PECOS PAC ID | 7810324811 |
|---|---|
| Medicare Enrollment ID | O20200304002160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972144319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jason D Landry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114135829 PECOS PAC ID: 1759456338 Enrollment ID: I20080815000461 |
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