| Medical & Surgical Clinic A Medical | |
|
1003 South Spruce St Vivian LA 71082-3200 | |
| (318) 375-3239 | |
| (318) 375-2755 |
| Full Name | Medical & Surgical Clinic A Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 1003 South Spruce St, Vivian, Louisiana |
| Authorized Official Name and Position | Pamela R. Hughes (ADMINISTRATOR) |
| Authorized Official Contact | 3183753239 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical & Surgical Clinic A Medical 1003 South Spruce St Vivian LA 71082-3200 Ph: (318) 375-3239 | Medical & Surgical Clinic A Medical 1003 South Spruce St Vivian LA 71082-3200 Ph: (318) 375-3239 |
| NPI Number | 1093744146 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 02/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093744146 | NPI | - | NPPES |
| 1942995 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
North Caddo Hospital Service District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 815 S Pine St, Vivian, LA 71082 Phone: 318-375-4007 | |
North Caddo Hospital Service District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 815 S Pine St, Vivian, LA 71082 Phone: 318-375-3239 Fax: 318-375-2755 |