Healthcare Provider Details

I. General information

NPI: 1972517746
Provider Name (Legal Business Name): HOUMA ORTHOPEDIC CLINIC AMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SCHOOL STREET SUITE B
HOUMA LA
70360-4691
US

IV. Provider business mailing address

1001 SCHOOL STREET SUITE B
HOUMA LA
70360-4691
US

V. Phone/Fax

Practice location:
  • Phone: 985-857-9790
  • Fax: 985-873-2968
Mailing address:
  • Phone: 985-857-9790
  • Fax: 985-873-2968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL PATRICK ALLEMAND
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 985-857-9790