| Christus Health Central Louisiana | |
|
17763 Highway 167 Dry Prong LA 71423-9205 | |
| (318) 899-5276 | |
| (318) 899-5932 |
| Full Name | Christus Health Central Louisiana |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 17763 Highway 167, Dry Prong, Louisiana |
| Authorized Official Name and Position | Monte Wilson (CEO) |
| Authorized Official Contact | 3374702100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christus Health Central Louisiana 3330 Masonic Dr Alexandria LA 71301-3841 Ph: (318) 483-4031 | Christus Health Central Louisiana 17763 Highway 167 Dry Prong LA 71423-9205 Ph: (318) 899-5276 |
| NPI Number | 1750400586 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 10/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750400586 | NPI | - | NPPES |
| 1446971 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | 234 (Louisiana) | Primary |
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