Healthcare Provider Details

I. General information

NPI: 1316115678
Provider Name (Legal Business Name): GWF INVESTMENTS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8742 GOODWOOD BLVD
BATON ROUGE LA
70806-7915
US

IV. Provider business mailing address

8742 GOODWOOD BLVD
BATON ROUGE LA
70806-7915
US

V. Phone/Fax

Practice location:
  • Phone: 225-231-7070
  • Fax:
Mailing address:
  • Phone: 225-231-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRAD FRICK
Title or Position: OWNER
Credential: PA
Phone: 225-231-7070