=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063211944
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLHG-AVOYELLES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2025
-----------------------------------------------------
Last Update Date | 07/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 409 CHOUPIQUE LN
-----------------------------------------------------
City | COTTONPORT
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71327-3737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-850-1010
-----------------------------------------------------
Fax | 318-240-6077
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 409 CHOUPIQUE LN
-----------------------------------------------------
City | COTTONPORT
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71327-3737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-850-1010
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | TIMOTHEY CURRY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 318-754-5052
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------