| Centerwell Senior Primary Care (la) Pc | |
|
2020 Bert Kouns Industrial Loop Shreveport LA 71118-3315 | |
| (407) 447-7120 | |
| Not Available |
| Full Name | Centerwell Senior Primary Care (la) Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2020 Bert Kouns Industrial Loop, Shreveport, Louisiana |
| Authorized Official Name and Position | Angie Martinez (SENIOR CREDENTIALING PROFESSIONAL) |
| Authorized Official Contact | 4074477120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centerwell Senior Primary Care (la) Pc 4700 Millenia Blvd Ste 650 Orlando FL 32839-6013 Ph: (407) 447-7120 | Centerwell Senior Primary Care (la) Pc 2020 Bert Kouns Industrial Loop Shreveport LA 71118-3315 Ph: (407) 447-7120 |
| NPI Number | 1497525661 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 01/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497525661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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