Sw Louisiana Internal Medicine Llc | |
105 Patriot St Ste 202 Lafayette LA 70508-6831 | |
(337) 257-2838 | |
Not Available |
Full Name | Sw Louisiana Internal Medicine Llc |
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Speciality | Internal Medicine |
Location | 105 Patriot St Ste 202, Lafayette, Louisiana |
Authorized Official Name and Position | Edward Kemp Coreil (PARTNER) |
Authorized Official Contact | 3372572838 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sw Louisiana Internal Medicine Llc 105 Patriot St Ste 202 Lafayette LA 70508-6831 Ph: () - | Sw Louisiana Internal Medicine Llc 105 Patriot St Ste 202 Lafayette LA 70508-6831 Ph: (337) 257-2838 |
NPI Number | 1376144501 |
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Provider Enumeration Date | 11/04/2020 |
Last Update Date | 11/04/2020 |
Medicare PECOS PAC ID | 8325450059 |
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Medicare Enrollment ID | O20201222000063 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376144501 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Edward K Coreil |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1407887441 PECOS PAC ID: 2567441488 Enrollment ID: I20040716000017 |
Provider Name | Karen R Smith |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942293329 PECOS PAC ID: 8123085420 Enrollment ID: I20041221000096 |
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