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General NPI Number Information
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NPI Number | 1851550552
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Entity Type | Organization
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Legal Business Name | WHEAT PYSCHIATRIC CLINIC A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 226 SOUTH DR
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City | NATCHITOCHES
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State | LA
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Zip | 71457-5041
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Country | US
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Telephone | 318-356-0220
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Fax |
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Provider Business Mailing Address
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Address Line | 242B KEYSER AVE SUITE 163
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City | NATCHITOCHES
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State | LA
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Zip | 71457-5102
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Country | US
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Telephone | 318-356-0220
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK T WHEAT
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Credential | MD
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Telephone | 318-356-0220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 021380
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License Number State | LA
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