| Philip A Landry Md A Professional Medical Corporation | |
|
216 Robin Ln Opelousas LA 70570-9149 | |
| (337) 942-5815 | |
| (337) 942-8004 |
| Full Name | Philip A Landry Md A Professional Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 216 Robin Ln, Opelousas, Louisiana |
| Authorized Official Name and Position | Philip A, Landry (OWNER) |
| Authorized Official Contact | 3379425815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip A Landry Md A Professional Medical Corporation Po Box 880 Opelousas LA 70571-0880 Ph: (337) 942-5815 | Philip A Landry Md A Professional Medical Corporation 216 Robin Ln Opelousas LA 70570-9149 Ph: (337) 942-5815 |
| NPI Number | 1245553023 |
|---|---|
| Provider Enumeration Date | 03/08/2010 |
| Last Update Date | 09/15/2022 |
| Certification Date | 09/15/2022 |
| Medicare PECOS PAC ID | 1951446517 |
|---|---|
| Medicare Enrollment ID | O20100308000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245553023 | NPI | - | NPPES |
| 1178756 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 012300 (Louisiana) | Primary |
| Provider Name | Philip A Landry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639218738 PECOS PAC ID: 1456314582 Enrollment ID: I20041109000838 |
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