Healthcare Provider Details

I. General information

NPI: 1821095407
Provider Name (Legal Business Name): INTERNAL MEDICINE CLINIC OF MORGAN CITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 MARGUERITE ST
MORGAN CITY LA
70380-1854
US

IV. Provider business mailing address

1126 MARGUERITE ST
MORGAN CITY LA
70380-1854
US

V. Phone/Fax

Practice location:
  • Phone: 985-702-8500
  • Fax: 985-702-8507
Mailing address:
  • Phone: 985-702-8500
  • Fax: 985-702-8507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number025614
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number025965
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number024914
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number024948
License Number StateLA

VIII. Authorized Official

Name: DR. FRANCIS H METZ III
Title or Position: DOCTOR
Credential: M.D.
Phone: 985-702-8500