| Independence Medical Clinic, Llc | |
|
281 W 4th St Independence LA 70443-2386 | |
| (504) 338-4268 | |
| Not Available |
| Full Name | Independence Medical Clinic, Llc |
|---|---|
| Speciality | General Practice |
| Location | 281 W 4th St, Independence, Louisiana |
| Authorized Official Name and Position | Edmond Wood (OWNER) |
| Authorized Official Contact | 5043384268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Medical Clinic, Llc 7300 Lakeshore Dr Apt 10 New Orleans LA 70124-2462 Ph: (504) 338-4268 | Independence Medical Clinic, Llc 281 W 4th St Independence LA 70443-2386 Ph: (504) 338-4268 |
| NPI Number | 1669897609 |
|---|---|
| Provider Enumeration Date | 02/27/2014 |
| Last Update Date | 07/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669897609 | NPI | - | NPPES |
| 1910864 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
Southeast Community Health Systems Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55420 N. Railroad Avenue, Independence, LA 70443 Phone: 225-306-2000 | |
Southeast Community Health Systems Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 336 East Railroad Avenue, Independence, LA 70443 Phone: 888-414-7247 | |
Multipractice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 281 W 4th St, Independence, LA 70443 Phone: 985-878-0066 Fax: 985-878-0969 | |
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