| St Elizabeth Physicians | |
|
2647 S St. Elizabeth Blvd Suite 100 Gonzales LA 70737-5021 | |
| (225) 647-8511 | |
| (225) 644-5213 |
| Full Name | St Elizabeth Physicians |
|---|---|
| Speciality | Family Medicine |
| Location | 2647 S St. Elizabeth Blvd, Gonzales, Louisiana |
| Authorized Official Name and Position | John F. Fraiche (PRESIDENT) |
| Authorized Official Contact | 2256478511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Elizabeth Physicians 2647 S St. Elizabeth Blvd Suite 100 Gonzales LA 70737-5021 Ph: (225) 647-8511 | St Elizabeth Physicians 2647 S St. Elizabeth Blvd Suite 100 Gonzales LA 70737-5021 Ph: (225) 647-8511 |
| NPI Number | 1306899067 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 03/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306899067 | NPI | - | NPPES |
| 1949892 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 013784 (Louisiana) | Primary |
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