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General NPI Number Information
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NPI Number | 1083073837
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Entity Type | Organization
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Legal Business Name | YOUNGSVILLE HEALTH, LLC
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 10/07/2016
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Provider Practice Location Address
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Address Line | 732 YOUNG ST
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-5501
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Country | US
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Telephone | 337-205-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 732 YOUNG ST
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-5501
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Country | US
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Telephone | 337-205-7777
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CORBETT J LEBOUEF III
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Credential |
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Telephone | 337-385-4143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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