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General NPI Number Information
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NPI Number | 1568487395
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Entity Type | Organization
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Legal Business Name | EDDY EMERGENCY GROUP LLC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 2430 W PIERCE ST
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City | CARLSBAD
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State | NM
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Zip | 88220-3553
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Country | US
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Telephone | 505-887-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CORPORATE BLVD SUITE 201
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City | LAFAYETTE
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State | LA
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Zip | 70508-3870
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Country | US
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Telephone | 800-893-9698
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. WILLIAM C. SCHUMACHER
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Credential | MD
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Telephone | 800-893-9698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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