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1054 Sw Railroad Ave Ponchatoula LA 70454-3557 | |
(855) 869-9898 | |
(985) 401-9898 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1054 Sw Railroad Ave, Ponchatoula, Louisiana |
Authorized Official Name and Position | Ernest Drake (CEO) |
Authorized Official Contact | 2252787691 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1054 Sw Railroad Ave Ponchatoula LA 70454-3557 Ph: (855) 869-9898 | 1054 Sw Railroad Ave Ponchatoula LA 70454-3557 Ph: (855) 869-9898 |
NPI Number | 1346895638 |
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Provider Enumeration Date | 08/05/2019 |
Last Update Date | 01/16/2025 |
Medicare PECOS PAC ID | 5294160859 |
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Medicare Enrollment ID | O20200109000559 |
Identifier | Type | State | Issuer |
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1346895638 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Michael J. Kozel, Md, A.p.m.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 165 W Oak St, Ponchatoula, LA 70454 Phone: 985-386-5943 Fax: 985-386-8080 | |
Allen's Family Practice Clinic Of Ponchatoula, L.l.p. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 105 E Oak St, Ponchatoula, LA 70454 Phone: 985-386-6198 Fax: 985-386-6223 |