| Zachary Internal Medicine Clinic Llc | |
|
1169 Highway 19 Ste B Slaughter LA 70777-3404 | |
| (225) 570-2257 | |
| (225) 286-4078 |
| Full Name | Zachary Internal Medicine Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1169 Highway 19 Ste B, Slaughter, Louisiana |
| Authorized Official Name and Position | Venu Babu Kakarala (OWNER) |
| Authorized Official Contact | 2255702257 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Zachary Internal Medicine Clinic Llc 1169 Highway 19 Ste B Slaughter LA 70777-3404 Ph: (225) 570-2257 | Zachary Internal Medicine Clinic Llc 1169 Highway 19 Ste B Slaughter LA 70777-3404 Ph: (225) 570-2257 |
| NPI Number | 1568488849 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 11/08/2021 |
| Medicare PECOS PAC ID | 1052324613 |
|---|---|
| Medicare Enrollment ID | O20060726000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568488849 | NPI | - | NPPES |
| 1569097 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Venu B Kakarala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538166822 PECOS PAC ID: 6002857208 Enrollment ID: I20050518000566 |
| Provider Name | Amy B Tomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497019376 PECOS PAC ID: 1951567197 Enrollment ID: I20120717000010 |
| Provider Name | Mallory S Bankston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174938211 PECOS PAC ID: 7416242524 Enrollment ID: I20160827000167 |
| Provider Name | Elizabeth A Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427453745 PECOS PAC ID: 8224334271 Enrollment ID: I20161122001683 |
| Provider Name | Heather P Garrot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972289031 PECOS PAC ID: 1153775986 Enrollment ID: I20230928000651 |
Baton Rouge Clinic, A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1169 Highway 19 Ste B, Slaughter, LA 70777 Phone: 225-570-2257 Fax: 225-286-4078 | |
Primary Care Providers For A Healthy Feliciana Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3166 Church St, Slaughter, LA 70777 Phone: 225-683-1370 Fax: 225-658-6500 | |
Zachary Internal Medicine Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1169 Highway 19 Ste B, Slaughter, LA 70777 Phone: 225-570-2257 Fax: 225-286-4078 |