institution
C V Guillermo Jr A Professional Medical Corp
General Practice Physician in Raceland, Louisiana
NPI 1417085143

C V Guillermo Jr A Professional Medical Corp is a General Practice Physician based in Raceland, LA. C V Guillermo Jr A Professional Medical Corp practices in Raceland, LA. The NPI Number for C V Guillermo Jr A Professional Medical Corp is 1417085143 and holds a License No. 03719R (Louisiana).

The current practice location address for C V Guillermo Jr A Professional Medical Corp is 4912 Highway 1, Raceland, LA and can be reached out via phone at 985-532-5092 and via fax at 985-532-8044.

Location: 4912 Highway 1, Raceland, LA, 70394
institution
Provider Profile Details
NPI Number
1417085143
Provider Name
C V Guillermo Jr A Professional Medical Corp
Credential
Provider Entity Type
Organization
Address
4912 Highway 1, Raceland, LA, 70394
Phone Number
985-532-5092
Fax Number
985-532-8044
Provider Enumeration Date
03/02/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1574214481 01 LA BLUE CROSS
1124087 05 LA
institution
Provider Business Practice Location Address Details
Address
4912 Highway 1
City
State
Zip
70394
Phone Number
985-532-5092
Fax Number
985-532-8044
person
Provider Business Mailing Address Details
Address
4912 Highway 1
City
State
Zip
70394
Phone Number
985-532-5092
Fax Number
985-532-8044
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
03719R (Louisiana)
Definition
Definition to come...
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