| The Family Care Center Of Southwest Louisiana, Llc | |
| 
					2345 Sampson St Westlake LA 70669-2711  | |
| (337) 439-1484 | |
| (337) 430-0927 | 
| Full Name | The Family Care Center Of Southwest Louisiana, Llc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 2345 Sampson St, Westlake, Louisiana | 
| Authorized Official Name and Position | Jody George (OWNER) | 
| Authorized Official Contact | 3374391484 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| The Family Care Center Of Southwest Louisiana, Llc 2345 Sampson St Westlake LA 70669-2711 Ph: (337) 439-1484  | The Family Care Center Of Southwest Louisiana, Llc 2345 Sampson St Westlake LA 70669-2711 Ph: (337) 439-1484  | 
| NPI Number | 1467675462 | 
|---|---|
| Provider Enumeration Date | 04/10/2007 | 
| Last Update Date | 01/10/2008 | 
| Medicare PECOS PAC ID | 1456445055 | 
|---|---|
| Medicare Enrollment ID | O20070913000094 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1467675462 | NPI | - | NPPES | 
| 1021571 | Medicaid | LA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Jody George | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1568592368 PECOS PAC ID: 2163516766 Enrollment ID: I20071031000114  | 
| Provider Name | Ramona Leigh Whittington | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1609191113 PECOS PAC ID: 6608909924 Enrollment ID: I20100805001148  | 
| Provider Name | Thomas James Baker | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1952981250 PECOS PAC ID: 2860895083 Enrollment ID: I20250304002130  | 
Randall K Wagman Md Apmc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2345 Sampson St, Westlake, LA 70669 Phone: 337-439-1484 Fax: 337-430-0927  |