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General NPI Number Information
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NPI Number | 1225840721
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Entity Type | Organization
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Legal Business Name | CLHG-ACADIAN LLC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 2048 JOHNSON HWY
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City | EUNICE
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State | LA
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Zip | 70535-6726
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Country | US
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Telephone | 337-457-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 HIGHWAY 190
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City | EUNICE
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State | LA
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Zip | 70535-5129
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID WAYNE INGRAM
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Credential |
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Telephone | 337-363-9486
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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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