| St. Marygrace Family Practice, Llc | |
|
1270 Attakapas Dr Suite 404 Opelousas LA 70570-6549 | |
| (337) 678-0918 | |
| (337) 678-0927 |
| Full Name | St. Marygrace Family Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1270 Attakapas Dr, Opelousas, Louisiana |
| Authorized Official Name and Position | Adenike A Tinubu (OWNER / OPERATOR / PHYSICIAN) |
| Authorized Official Contact | 3376780918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Marygrace Family Practice, Llc 1270 Attakapas Dr Suite 404 Opelousas LA 70570-6549 Ph: (337) 678-0918 | St. Marygrace Family Practice, Llc 1270 Attakapas Dr Suite 404 Opelousas LA 70570-6549 Ph: (337) 678-0918 |
| NPI Number | 1639301732 |
|---|---|
| Provider Enumeration Date | 08/23/2009 |
| Last Update Date | 03/18/2011 |
| Medicare PECOS PAC ID | 4183770480 |
|---|---|
| Medicare Enrollment ID | O20090928000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639301732 | NPI | - | NPPES |
| 1306055652 | Other | LA | DR'S NPI |
| 4507245 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 202981 (Louisiana) | Primary |
| Provider Name | Adenike A Tinubu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306055652 PECOS PAC ID: 5193871499 Enrollment ID: I20090928000414 |
Opelousas General Health System Physician Practices Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 827 N Union St, Opelousas, LA 70570 Phone: 337-948-1802 Fax: 337-942-9074 | |
Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3921 I 49 S Service Rd, Opelousas, LA 70570 Phone: 337-942-5706 Fax: 337-942-2644 | |
Southwest Louisiana Primary Health Care Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8762 Highway 182, Opelousas, LA 70570 Phone: 337-942-2005 Fax: 337-942-8644 | |
Alan J Sonsky Md Apmc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3975 I49 South Service Road, Suite 230, Opelousas, LA 70570 Phone: 337-948-7040 | |
Metoyer Medical Corporation Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 204 W North St, Opelousas, LA 70570 Phone: 337-948-4445 Fax: 337-948-1118 | |
Loyd H Boulet Jr Md A Professional Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Attakapas Dr, Opelousas, LA 70570 Phone: 337-942-6324 | |
Ochsner Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3975 I 49 S Service Rd Ste 205-a, Opelousas, LA 70570 Phone: 337-942-1151 Fax: 337-678-3339 |