| Occupational & Integrative Medicine, Llc | |
|
221 Southpark Rd Ste B Lafayette LA 70508-3611 | |
| (337) 534-0420 | |
| (337) 806-9576 |
| Full Name | Occupational & Integrative Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 221 Southpark Rd Ste B, Lafayette, Louisiana |
| Authorized Official Name and Position | Donna B Wilson (NURSE PRACTITIONER) |
| Authorized Official Contact | 3375340420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Occupational & Integrative Medicine, Llc 221 Southpark Rd Ste B Lafayette LA 70508-3611 Ph: (337) 534-0420 | Occupational & Integrative Medicine, Llc 221 Southpark Rd Ste B Lafayette LA 70508-3611 Ph: (337) 534-0420 |
| NPI Number | 1477398956 |
|---|---|
| Provider Enumeration Date | 06/27/2024 |
| Last Update Date | 10/31/2024 |
| Medicare PECOS PAC ID | 8527504331 |
|---|---|
| Medicare Enrollment ID | O20240729000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477398956 | NPI | - | NPPES |
| Provider Name | Donna Boudreaux Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982196432 PECOS PAC ID: 0648524017 Enrollment ID: I20181121002015 |
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