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General NPI Number Information
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NPI Number | 1174514533
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Entity Type | Organization
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Legal Business Name | SULPHUR URGENT CARE, LLC
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 3924 MAPLEWOOD DR
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City | SULPHUR
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State | LA
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Zip | 70663-6352
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Country | US
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Telephone | 337-626-0078
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Fax | 337-626-0330
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Provider Business Mailing Address
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Address Line | 3924 MAPLEWOOD DR
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City | SULPHUR
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State | LA
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Zip | 70663-6352
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Country | US
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Telephone | 337-626-0078
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Fax | 337-626-0330
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERRY DWAYNE HELMS
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Credential | M.D.
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Telephone | 337-626-0078
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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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