| Medical Center Family Dentistry | |
|
307 Chisum St Sicily Island LA 71368-4807 | |
| (318) 389-9941 | |
| (318) 389-4028 |
| Full Name | Medical Center Family Dentistry |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 307 Chisum St, Sicily Island, Louisiana |
| Authorized Official Name and Position | Debra K Miesch (CEO) |
| Authorized Official Contact | 3183895727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center Family Dentistry Po Box 8 307 Chisum Street Sicily Island LA 71368-0008 Ph: (318) 389-5727 | Medical Center Family Dentistry 307 Chisum St Sicily Island LA 71368-4807 Ph: (318) 389-9941 |
| NPI Number | 1225183916 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 05/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225183916 | NPI | - | NPPES |
| 1940801 | Medicaid | LA | |
| 1855391 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 5539 (Louisiana) | Primary |
Catahoula Parish Hospital District No 2 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Chisum Street, Sicily Island, LA 71368 Phone: 318-389-5727 Fax: 318-389-9943 | |
Island Medical Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 307 Chisum Street, Sicily Island, LA 71368 Phone: 318-389-5727 Fax: 318-389-4028 | |
Harrisonburg Family Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 307 Chisum St, Sicily Island, LA 71368 Phone: 318-389-5727 Fax: 318-389-4028 |