Randall K Wagman Md Apmc | |
2345 Sampson St Westlake LA 70669-2711 | |
(337) 439-1484 | |
(337) 430-0927 |
Full Name | Randall K Wagman Md Apmc |
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Speciality | Family Medicine |
Location | 2345 Sampson St, Westlake, Louisiana |
Authorized Official Name and Position | Randall Wagman (OWNER) |
Authorized Official Contact | 3374391484 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Randall K Wagman Md Apmc 2345 Sampson St Westlake LA 70669-2711 Ph: (337) 439-1484 | Randall K Wagman Md Apmc 2345 Sampson St Westlake LA 70669-2711 Ph: (337) 439-1484 |
NPI Number | 1396951307 |
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Provider Enumeration Date | 05/15/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396951307 | NPI | - | NPPES |
1945323 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 11202R (Louisiana) | Primary |
The Family Care Center Of Southwest Louisiana, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2345 Sampson St, Westlake, LA 70669 Phone: 337-439-1484 Fax: 337-430-0927 |