| Southern Medical Associates | |
|
2524 S. Philippe Avenue Gonzales LA 70737 | |
| (225) 644-1990 | |
| (225) 644-3264 |
| Full Name | Southern Medical Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 2524 S. Philippe Avenue, Gonzales, Louisiana |
| Authorized Official Name and Position | Gertrude Gboloo (OWNER) |
| Authorized Official Contact | 2256441990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Medical Associates P.o. Box 1388 Gonzales LA 70737 Ph: (225) 644-1990 | Southern Medical Associates 2524 S. Philippe Avenue Gonzales LA 70737 Ph: (225) 644-1990 |
| NPI Number | 1861646739 |
|---|---|
| Provider Enumeration Date | 11/05/2008 |
| Last Update Date | 11/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861646739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD.202326 (Louisiana) | Secondary |
| 207R00000X | Internal Medicine | (Louisiana) | Primary |
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