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General NPI Number Information
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NPI Number | 1730722471
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Entity Type | Organization
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Legal Business Name | DM PROPERTIES OF LAFAYETTE, LLC
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | 3662 W OAK ST
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City | JENA
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State | LA
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Zip | 71342
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Country | US
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Telephone | 318-495-2273
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Fax | 318-374-4013
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Provider Business Mailing Address
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Address Line | 3601 JACKSON ST EXT
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3002
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Country | US
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Telephone | 318-787-6877
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Fax | 318-787-6896
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DEEPAK SHARMA
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Credential |
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Telephone | 318-787-6877
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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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