| Maison De Lafayette | |
|
2707 Kaliste Saloom Rd Lafayette LA 70508-7139 | |
| (337) 981-2258 | |
| Not Available |
| Full Name | Maison De Lafayette |
|---|---|
| Speciality | Family Medicine |
| Location | 2707 Kaliste Saloom Rd, Lafayette, Louisiana |
| Authorized Official Name and Position | William J Mcpherson (PARTNER) |
| Authorized Official Contact | 3187295696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maison De Lafayette 2707 Kaliste Saloom Rd Lafayette LA 70508-7139 Ph: (337) 981-2258 | Maison De Lafayette 2707 Kaliste Saloom Rd Lafayette LA 70508-7139 Ph: (337) 981-2258 |
| NPI Number | 1104170992 |
|---|---|
| Provider Enumeration Date | 11/01/2012 |
| Last Update Date | 01/26/2022 |
| Medicare PECOS PAC ID | 6002076668 |
|---|---|
| Medicare Enrollment ID | O20130413000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104170992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Dawn Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467932889 PECOS PAC ID: 7012267099 Enrollment ID: I20180912003260 |
| Provider Name | Bridget Landry Crochet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689162828 PECOS PAC ID: 5496167553 Enrollment ID: I20201214001829 |
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