| Nwabueze Nnamdi Inc | |
|
3050 Charles Dr Jackson LA 70748-6135 | |
| (225) 634-3517 | |
| (225) 635-5057 |
| Full Name | Nwabueze Nnamdi Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3050 Charles Dr, Jackson, Louisiana |
| Authorized Official Name and Position | Stacie N Nwabueze (ADMINISTRATOR) |
| Authorized Official Contact | 2256343517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nwabueze Nnamdi Inc 3050 Charles Dr Jackson LA 70748-6135 Ph: (225) 634-3517 | Nwabueze Nnamdi Inc 3050 Charles Dr Jackson LA 70748-6135 Ph: (225) 634-3517 |
| NPI Number | 1114047735 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 07/06/2015 |
| Medicare PECOS PAC ID | 8426019712 |
|---|---|
| Medicare Enrollment ID | O20041020000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114047735 | NPI | - | NPPES |
| 1552232 | Medicaid | LA | |
| 2330241 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | L12712R (Louisiana) | Secondary |
| 207R00000X | Internal Medicine | L12712R (Louisiana) | Primary |
| Provider Name | Nnamdi A Nwabueze |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871525667 PECOS PAC ID: 3577524867 Enrollment ID: I20041020000797 |
Primary Care Providers For A Healthy Feliciana, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3619 Highway 10, Jackson, LA 70748 Phone: 225-683-1360 Fax: 225-634-0005 |