Northlake Primary Care

NPI 1063638831 - Internal Medicine - 207R00000X

NPI Details
NPI 1063638831
Enumeration Date 04/18/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JOSE ANTONIO JOSE
Position DOCTOR
Phone (985) 641-6454
Fax (985) 641-6458
Practice Location
951 GAUSE BLVD STE 2
SLIDELL LA, 70458-2937, US
Phone (985) 641-6454
Fax (985) 641-6458
Business Location
951 GAUSE BLVD STE 2
SLIDELL LA, 70458-2937, US
Phone (985) 641-6454
Fax (985) 641-6458
Toxanomy
Taxonomy Code 207R00000X
License State Louisiana
License Number MD11789R
Remove 1063638831 NPI Number
 

According to our database, Northlake Primary Care NPI is 1063638831, taxonomy code is 207R00000X and license number is MD11789R, license state is located at Louisiana. Northlake Primary Care physically located at 951 Gause Blvd Ste 2, Slidell LA, 70458-2937. NPI Number 1033115704 has the healthcare provider type.

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1063638831 NPI number is provided on an as is basis without warranty of any kind. 1063638831 is maintained by the National Plan & Provider Enumeration System. The contents of Northlake Primary Care are for informational purposes only.