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NPI Code Detail

MEDICARE: ADULT MEDICINE INSTITUTE & DIAGNOSTIC CENTER

MEDICARE: ADULT MEDICINE INSTITUTE & DIAGNOSTIC CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center022083LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578885240
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADULT MEDICINE INSTITUTE & DIAGNOSTIC CENTER
Provider Business Mailing Address
First Line : 1937 S BURNSIDE AVE
Second Line :
City : GONZALES
State : LA
Zip : 70737-4632
Country : US
Telephone Number : 225-647-1947
Fax Number : 225-644-3943
Provider Business Practice Location Address
First Line : 1937 S BURNSIDE AVE
Second Line :
City : GONZALES
State : LA
Zip : 70737-4632
Country : US
Telephone Number : 225-647-1947
Fax Number : 225-644-3943
Authorized Official
Title or Position : OWNER
Name : CARLOS RUBEN VAZQUEZ
Credential : M.D.
Telephone Number : 225-647-1947
Provider Enumeration Date : 02/23/2010
Last Update Date : 02/23/2010

Similar Medicare Providers

1942205174 — DR. JASON D. ADAMS M.D.
Practice Location Address:
1943A SOUTH BURNSIDE
GONZALES, LA
70737-4632
Practice Phone: 225-647-2294
Practice Fax: 225-647-2295
1720078603 — DAWN ZITMAN M.D.
Practice Location Address:
1937 S BURNSIDE AVE
GONZALES, LA
70737-4632
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1023250222 — CAMMIE A HILLIARD MD
Practice Location Address:
1937 S BURNSIDE AVE
GONZALES, LA
70737-4632
Practice Phone: 225-765-5500
Practice Fax: 225-644-9286
1720306558 — TRACY WALLACE MD
Practice Location Address:
1937 S BURNSIDE AVE
GONZALES, LA
70737-4632
Practice Phone: 225-765-5500
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1821382631 — MRS. PAULA DENISE JULIAN APRN, FNP-C
Practice Location Address:
1937 S BURNSIDE AVE
GONZALES, LA
70737-4632
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Practice Fax:
1356681761 — STEPHANIE COCHRAN WESELAK NP
Practice Location Address:
1937 S BURNSIDE AVE
GONZALES, LA
70737-4632
Practice Phone: 225-765-5500
Practice Fax: 225-644-9286

Directions to “ADULT MEDICINE INSTITUTE & DIAGNOSTIC CENTER ” Practice Location

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