| Dixon Family Medical Center, Llc | |
|
536 St. Landry Veterans Memorial Hwy. Washington LA 70589-4420 | |
| (337) 628-5014 | |
| (337) 826-5401 |
| Full Name | Dixon Family Medical Center, Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 536 St. Landry Veterans Memorial Hwy., Washington, Louisiana |
| Authorized Official Name and Position | Monique Bianca Declouet-dixon (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 3376285014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dixon Family Medical Center, Llc Po Box 596 Washington LA 70589-0596 Ph: (337) 628-5014 | Dixon Family Medical Center, Llc 536 St. Landry Veterans Memorial Hwy. Washington LA 70589-4420 Ph: (337) 628-5014 |
| NPI Number | 1366847337 |
|---|---|
| Provider Enumeration Date | 11/03/2014 |
| Last Update Date | 09/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366847337 | NPI | - | NPPES |
| 1820105 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | AP05959 (Louisiana) | Primary |
St. Landry Family Healthcare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 536 Veterans Blvd, Washington, LA 70589 Phone: 337-826-7702 Fax: 337-623-5788 |