| Executive Health | |
|
1122 South Bernard Suite C Broussard LA 70518-3408 | |
| (337) 703-6476 | |
| (337) 703-6477 |
| Full Name | Executive Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 1122 South Bernard, Broussard, Louisiana |
| Authorized Official Name and Position | Kim Dooley (VP) |
| Authorized Official Contact | 3375711394 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Health Po Box 919229 Dallas TX 75391-9229 Ph: (337) 289-8944 | Executive Health 1122 South Bernard Suite C Broussard LA 70518-3408 Ph: (337) 703-6476 |
| NPI Number | 1699447243 |
|---|---|
| Provider Enumeration Date | 10/01/2021 |
| Last Update Date | 10/19/2021 |
| Certification Date | 10/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699447243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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