| Premise Health Of Louisiana Medical Professional Medical Corporation | |
| 
					14902 River Rd Norco LA 70079-2543  | |
| (985) 764-4666 | |
| (985) 764-4568 | 
| Full Name | Premise Health Of Louisiana Medical Professional Medical Corporation | 
|---|---|
| Speciality | Clinic/center - Multi-specialty | 
| Location | 14902 River Rd, Norco, Louisiana | 
| Authorized Official Name and Position | Jonathan B Leizman (PRESIDENT) | 
| Authorized Official Contact | 6154686270 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Premise Health Of Louisiana Medical Professional Medical Corporation 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () -  | Premise Health Of Louisiana Medical Professional Medical Corporation 14902 River Rd Norco LA 70079-2543 Ph: (985) 764-4666  | 
| NPI Number | 1609698877 | 
|---|---|
| Provider Enumeration Date | 10/29/2024 | 
| Last Update Date | 10/29/2024 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1609698877 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary | 
Access Health Louisiana Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16004 River Rd, Norco, LA 70079 Phone: 985-725-9330 Fax: 504-575-3691  |