Med Ed Of Louisiana, Inc. | |
209 Champagne Blvd. Breaux Bridge LA 70517-3700 | |
(337) 332-0222 | |
(337) 332-1102 |
Full Name | Med Ed Of Louisiana, Inc. |
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Speciality | Family Medicine |
Location | 209 Champagne Blvd., Breaux Bridge, Louisiana |
Authorized Official Name and Position | Jahanyar Khorsandi (PRESIDENT) |
Authorized Official Contact | 3373320222 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Med Ed Of Louisiana, Inc. 209 Champagne Blvd Breaux Bridge LA 70517-3700 Ph: (337) 332-0222 | Med Ed Of Louisiana, Inc. 209 Champagne Blvd. Breaux Bridge LA 70517-3700 Ph: (337) 332-0222 |
NPI Number | 1114086576 |
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Provider Enumeration Date | 12/08/2006 |
Last Update Date | 12/31/2015 |
Medicare PECOS PAC ID | 9739164351 |
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Medicare Enrollment ID | O20040618001301 |
Identifier | Type | State | Issuer |
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1114086576 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 023722 (Louisiana) | Primary |
Provider Name | Jahanyar Khorsandi |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215990932 PECOS PAC ID: 0143205542 Enrollment ID: I20040621000940 |
Provider Name | Claire Duos Joubert |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306272281 PECOS PAC ID: 3072742907 Enrollment ID: I20140218001547 |
Provider Name | Stacey Savoy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528428844 PECOS PAC ID: 1456646793 Enrollment ID: I20160825000221 |
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