| Southside Family Clinic Llc | |
|
304 N Hospital Dr Ste A Abbeville LA 70510-4041 | |
| (337) 580-4061 | |
| Not Available |
| Full Name | Southside Family Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 304 N Hospital Dr Ste A, Abbeville, Louisiana |
| Authorized Official Name and Position | John Dies (PRESIDENT) |
| Authorized Official Contact | 3375804061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Family Clinic Llc 304 N Hospital Dr Ste A Abbeville LA 70510-4041 Ph: (337) 385-1972 | Southside Family Clinic Llc 304 N Hospital Dr Ste A Abbeville LA 70510-4041 Ph: (337) 580-4061 |
| NPI Number | 1720508955 |
|---|---|
| Provider Enumeration Date | 06/20/2017 |
| Last Update Date | 04/28/2018 |
| Medicare PECOS PAC ID | 3779859392 |
|---|---|
| Medicare Enrollment ID | O20171026002838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720508955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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