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General NPI Number Information
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NPI Number | 1700251253
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Entity Type | Organization
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Legal Business Name | PHYSICIANS MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 131 CORPORATE DR
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City | HOUMA
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State | LA
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Zip | 70360-2767
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Country | US
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Telephone | 985-580-9990
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Fax | 985-580-9984
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Provider Business Mailing Address
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Address Line | 218 CORPORATE DR
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City | HOUMA
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State | LA
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Zip | 70360-2768
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Country | US
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Telephone | 985-580-9990
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Fax | 985-580-9984
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER BOYD BALDOCK
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Credential |
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Telephone | 615-234-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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