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General NPI Number Information
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NPI Number | 1427885821
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Entity Type | Organization
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Legal Business Name | TUNICA- BILOXI TRIBE OF LOUISIANA TRIBAL OFFICE
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Dates
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Enumeration Date | 09/18/2024
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 597 TUNICA DR W
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City | MARKSVILLE
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State | LA
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Zip | 71351-2628
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Country | US
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Telephone | 318-240-6435
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Fax | 318-253-0083
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Provider Business Mailing Address
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Address Line | 171 MELANCON RD
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City | MARKSVILLE
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State | LA
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Zip | 71351-3065
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Country | US
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Telephone | 318-240-6435
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Fax | 318-253-0083
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Authorized Official
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Title or Position | HEALTH DIRECTOR
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Name | CAMERON MITCHELLE CHASE
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Credential |
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Telephone | 318-359-3659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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