Healthcare Provider Details

I. General information

NPI: 1235033093
Provider Name (Legal Business Name): NRMC PHYSICIAN IPA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 KEYSER AVENUE
NATCHITOCHES LA
71457
US

IV. Provider business mailing address

PO BOX 2009
NATCHITOCHES LA
71457
US

V. Phone/Fax

Practice location:
  • Phone: 318-214-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAMIAN KIRK SOILEAU
Title or Position: CEO
Credential:
Phone: 318-214-4512