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General NPI Number Information
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NPI Number | 1659566982
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICINE ASSOCIATES OF MINDEN, LLC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 1111 HOMER RD
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City | MINDEN
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State | LA
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Zip | 71055-3027
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Country | US
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Telephone | 318-377-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 HOMER RD
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City | MINDEN
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State | LA
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Zip | 71055-3027
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Country | US
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Telephone | 318-377-7500
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. CELESTE GAUBERT
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Credential |
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Telephone | 504-866-3017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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