| Providence Medical Clinic | |
|
9270 Siegen Ln Suite 202 Baton Rouge LA 70810-1998 | |
| (225) 766-8152 | |
| Not Available |
| Full Name | Providence Medical Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 9270 Siegen Ln, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Cuong Minh Pho (OFFICE MANAGER) |
| Authorized Official Contact | 2257668152 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Clinic 1229 Tanglebriar Dr Baton Rouge LA 70810-5195 Ph: (225) 766-4213 | Providence Medical Clinic 9270 Siegen Ln Suite 202 Baton Rouge LA 70810-1998 Ph: (225) 766-8152 |
| NPI Number | 1700092442 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700092442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Louisiana) | Primary |
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