Wellington Provider Group Pc | |
650 Poydras St Ste 1400 New Orleans LA 70130-6116 | |
(859) 518-8817 | |
(859) 201-1084 |
Full Name | Wellington Provider Group Pc |
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Speciality | Family Medicine |
Location | 650 Poydras St Ste 1400, New Orleans, Louisiana |
Authorized Official Name and Position | Mariela Bravo (CREDENTIALING TEAM LEAD) |
Authorized Official Contact | 8595188817 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wellington Provider Group Pc 535 Wellington Way Ste 330 Lexington KY 40503-1331 Ph: (859) 518-8817 | Wellington Provider Group Pc 650 Poydras St Ste 1400 New Orleans LA 70130-6116 Ph: (859) 518-8817 |
NPI Number | 1255043378 |
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Provider Enumeration Date | 12/20/2022 |
Last Update Date | 12/20/2022 |
Medicare PECOS PAC ID | 8123412459 |
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Medicare Enrollment ID | O20230410000760 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255043378 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Carl Seger |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699957308 PECOS PAC ID: 1951455773 Enrollment ID: I20230410000910 |
Provider Name | Kyle George |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982199519 PECOS PAC ID: 4688909690 Enrollment ID: I20230511000549 |
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