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General NPI Number Information
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NPI Number | 1992896484
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Entity Type | Organization
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Legal Business Name | GREENWELL MEDICAL CLINIC LLC DBA NORTH POINT FAMILY HEALTH
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 09/04/2014
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Provider Practice Location Address
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Address Line | 18901 GREENWELL SPRINGS RD
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City | GREENWELL SPRINGS
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State | LA
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Zip | 70739-4836
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Country | US
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Telephone | 225-924-9985
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Fax | 225-924-0884
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Provider Business Mailing Address
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Address Line | 18901 GREENWELL SPRINGS RD
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City | GREENWELL SPRINGS
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State | LA
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Zip | 70739-4836
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Country | US
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Telephone | 225-924-9985
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Fax | 225-924-0884
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ROBERT KYLE DEAN
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Credential | MD
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Telephone | 225-924-9985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 05798R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 10977
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11621R
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License Number State | LA
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