| Trudy H Sanson Md A Medical Corp | |
|
102 Thomas Rd Suite 206 West Monroe LA 71291-7366 | |
| (318) 387-0641 | |
| (318) 387-0645 |
| Full Name | Trudy H Sanson Md A Medical Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 102 Thomas Rd, West Monroe, Louisiana |
| Authorized Official Name and Position | Trudy H Sanson (OWNER) |
| Authorized Official Contact | 3183870641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trudy H Sanson Md A Medical Corp 102 Thomas Rd Suite 206 West Monroe LA 71291-7366 Ph: (318) 387-0641 | Trudy H Sanson Md A Medical Corp 102 Thomas Rd Suite 206 West Monroe LA 71291-7366 Ph: (318) 387-0641 |
| NPI Number | 1609994714 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/04/2010 |
| Medicare PECOS PAC ID | 9931159290 |
|---|---|
| Medicare Enrollment ID | O20050125000873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609994714 | NPI | - | NPPES |
| 1399922 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 017870 (Louisiana) | Primary |
| Provider Name | Trudy H Sanson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1104889781 PECOS PAC ID: 6901856160 Enrollment ID: I20101006000718 |
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