| None | |
|
136 Tower Rd Crowley LA 70526-2211 | |
| (337) 783-4034 | |
| (337) 783-4053 |
| Full Name | None |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 136 Tower Rd, Crowley, Louisiana |
| Authorized Official Name and Position | Robert Joseph Aertker (INTERNIST) |
| Authorized Official Contact | 3377834043 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None Po Box 444 Crowley LA 70527-0444 Ph: (337) 783-4034 | None 136 Tower Rd Crowley LA 70526-2211 Ph: (337) 783-4034 |
| NPI Number | 1699083188 |
|---|---|
| Provider Enumeration Date | 09/17/2010 |
| Last Update Date | 09/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699083188 | NPI | - | NPPES |
| 1500526 | Medicaid | LA | |
| 1780877944 | Other | LA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD.201790 (Louisiana) | Primary |
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