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NPI Code Detail

MEDICARE: THE CARING CLINIC OF LOUISIANA, LLC

MEDICARE: THE CARING CLINIC OF LOUISIANA, LLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1679762421
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CARING CLINIC OF LOUISIANA, LLC
Provider Business Mailing Address
First Line : 4550 NORTH BLVD
Second Line : SUITE 115
City : BATON ROUGE
State : LA
Zip : 70806-4013
Country : US
Telephone Number : 225-341-5901
Fax Number : 225-341-5903
Provider Business Practice Location Address
First Line : 4550 NORTH BLVD
Second Line : SUITE 115
City : BATON ROUGE
State : LA
Zip : 70806-4013
Country : US
Telephone Number : 225-341-5901
Fax Number : 225-341-5903
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. TIMOTHY J. YOUNG
Credential :
Telephone Number : 225-341-5901
Provider Enumeration Date : 10/17/2007
Last Update Date : 01/28/2008

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Directions to “THE CARING CLINIC OF LOUISIANA, LLC ” Practice Location

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