| West Jefferson Physician Services | |
|
5140 Church St Lafitte LA 70067-5256 | |
| (504) 349-6525 | |
| (504) 349-6529 |
| Full Name | West Jefferson Physician Services |
|---|---|
| Speciality | Family Medicine |
| Location | 5140 Church St, Lafitte, 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 5140 Church St Lafitte LA 70067-5256 Ph: (504) 349-6525 | West Jefferson Physician Services 5140 Church St Lafitte LA 70067-5256 Ph: (504) 349-6525 |
| NPI Number | 1831266162 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831266162 | NPI | - | NPPES |
| 1942545 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Jefferson Community Health Care Centers, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5140 Church St, Lafitte, LA 70067 Phone: 504-689-3300 | |
Jefferson Community Health Care Centers, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5140 Church St, Lafitte, LA 70067 Phone: 504-689-3300 Fax: 504-689-8223 |