| Southeast Family Medical Practice | |
|
1320 N Morrison Blvd Ste 125 Hammond LA 70401-2242 | |
| (985) 402-3762 | |
| (985) 256-2591 |
| Full Name | Southeast Family Medical Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1320 N Morrison Blvd Ste 125, Hammond, Louisiana |
| Authorized Official Name and Position | Jazmin Escalante (NURSE PRACTITIONER) |
| Authorized Official Contact | 9854023762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Family Medical Practice 1320 N Morrison Blvd Ste 125 Hammond LA 70401-2242 Ph: (985) 402-3762 | Southeast Family Medical Practice 1320 N Morrison Blvd Ste 125 Hammond LA 70401-2242 Ph: (985) 402-3762 |
| NPI Number | 1346874732 |
|---|---|
| Provider Enumeration Date | 02/25/2020 |
| Last Update Date | 05/05/2020 |
| Medicare PECOS PAC ID | 5395169445 |
|---|---|
| Medicare Enrollment ID | O20200722000487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346874732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Jazmin I Escalante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982112462 PECOS PAC ID: 4789949447 Enrollment ID: I20180530000369 |
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