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General NPI Number Information
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NPI Number | 1134189012
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Entity Type | Organization
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Legal Business Name | JEFF DAVIS FAMILY MEDICINE A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 1322 ELTON RD SUITE D
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City | JENNINGS
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State | LA
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Zip | 70546-4138
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Country | US
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Telephone | 337-824-1111
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Fax | 337-824-1122
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Provider Business Mailing Address
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Address Line | 1322 ELTON RD SUITE D
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City | JENNINGS
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State | LA
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Zip | 70546-4138
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Country | US
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Telephone | 337-824-1111
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Fax | 337-824-1122
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CHRISTOPHER ACHEE
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Credential | M.D.
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Telephone | 337-824-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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