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1884 Highway 165 S Oakdale LA 71463-3500 | |
(318) 335-3501 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1884 Highway 165 S, Oakdale, Louisiana |
Authorized Official Name and Position | Suzette Fatula (CFO) |
Authorized Official Contact | 3182153223 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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130 Hospital Dr Oakdale LA 71463-3035 Ph: (318) 215-3431 | 1884 Highway 165 S Oakdale LA 71463-3500 Ph: (318) 335-3501 |
NPI Number | 1730628975 |
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Provider Enumeration Date | 02/21/2017 |
Last Update Date | 07/25/2024 |
Medicare PECOS PAC ID | 1355623943 |
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Medicare Enrollment ID | O20180306000614 |
Identifier | Type | State | Issuer |
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1730628975 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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