| West Jefferson Physician Services | |
|
3909 Lapalco Blvd Suite 100 Harvey LA 70058-2302 | |
| (504) 349-6900 | |
| (504) 340-4305 |
| Full Name | West Jefferson Physician Services |
|---|---|
| Speciality | Pediatrics |
| Location | 3909 Lapalco Blvd, Harvey, Louisiana |
| Authorized Official Name and Position | Heidi A Gwinn (CREDENTIALING COORD.) |
| Authorized Official Contact | 5043491297 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Jefferson Physician Services 3909 Lapalco Blvd Suite 100 Harvey LA 70058-2302 Ph: (504) 349-6900 | West Jefferson Physician Services 3909 Lapalco Blvd Suite 100 Harvey LA 70058-2302 Ph: (504) 349-6900 |
| NPI Number | 1790850774 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790850774 | NPI | - | NPPES |
| 1942545 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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