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NPI Code Detail

MEDICARE: DR. CARL EUGENE MCLEMORE JR. M.D.

MEDICARE: DR. CARL EUGENE MCLEMORE JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician013318LA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1193857OTHERLAMEDICARE GROUP # FOR RURAL HEALTH
2080186474OTHERLARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073513941
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL EUGENE MCLEMORE JR. M.D.
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 225-526-0011
Fax Number : 225-765-9196
Provider Business Practice Location Address
First Line : 310 DUREL DR
Second Line :
City : NEW ROADS
State : LA
Zip : 70760-2973
Country : US
Telephone Number : 225-713-2400
Fax Number : 225-713-2405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 02/19/2021

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