| The Magnolia Clinic | |
|
914 S Post Oak Rd Sulphur LA 70663-5246 | |
| (337) 625-0035 | |
| (337) 625-0036 |
| Full Name | The Magnolia Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 914 S Post Oak Rd, Sulphur, Louisiana |
| Authorized Official Name and Position | Susan L Duhon (NURSE PRACTITIONER) |
| Authorized Official Contact | 3376250035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Magnolia Clinic 914 S Post Oak Rd Sulphur LA 70663-5246 Ph: (337) 625-0035 | The Magnolia Clinic 914 S Post Oak Rd Sulphur LA 70663-5246 Ph: (337) 625-0035 |
| NPI Number | 1366568800 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7416243910 |
|---|---|
| Medicare Enrollment ID | O20160909000949 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366568800 | NPI | - | NPPES |
| 1440639 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Louisiana) | Primary |
| Provider Name | Susan L Duhon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437275997 PECOS PAC ID: 8325334824 Enrollment ID: I20161114000811 |
| Provider Name | Kemoshia R Brandon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972964740 PECOS PAC ID: 4183966112 Enrollment ID: I20190423002253 |
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