| Randall K Wagman Md Apmc | |
|
2345 Sampson St Westlake LA 70669-2711 | |
| (337) 439-1484 | |
| (337) 430-0927 |
| Full Name | Randall K Wagman Md Apmc |
|---|---|
| Speciality | Family Medicine |
| Location | 2345 Sampson St, Westlake, Louisiana |
| Authorized Official Name and Position | Randall Wagman (OWNER) |
| Authorized Official Contact | 3374391484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randall K Wagman Md Apmc 2345 Sampson St Westlake LA 70669-2711 Ph: (337) 439-1484 | Randall K Wagman Md Apmc 2345 Sampson St Westlake LA 70669-2711 Ph: (337) 439-1484 |
| NPI Number | 1396951307 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396951307 | NPI | - | NPPES |
| 1945323 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11202R (Louisiana) | Primary |
The Family Care Center Of Southwest Louisiana, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2345 Sampson St, Westlake, LA 70669 Phone: 337-439-1484 Fax: 337-430-0927 |