institution
Destrehan Medical Clinic
Primary Care Clinic/Center in Destrehan, Louisiana
NPI 1790876019

Destrehan Medical Clinic is a Primary Care Clinic/Center based in Destrehan, LA and is specialized in Primary Care. Destrehan Medical Clinic practices in Destrehan, LA. The NPI Number for Destrehan Medical Clinic is 1790876019 and holds a License No. (Louisiana).

The current practice location address for Destrehan Medical Clinic is 12604 River Rd, Destrehan, LA and can be reached out via phone at 985-764-0439 and via fax at 985-725-1464.

Location: 12604 River Rd, Destrehan, LA, 70047-5306
institution
Provider Profile Details
NPI Number
1790876019
Provider Name
Destrehan Medical Clinic
Credential
Provider Entity Type
Organization
Address
12604 River Rd, Destrehan, LA, 70047-5306
Phone Number
985-764-0439
Fax Number
985-725-1464
Provider Enumeration Date
09/28/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1798703 05 LA
institution
Provider Business Practice Location Address Details
Address
12604 River Rd
City
State
Zip
70047-5306
Phone Number
985-764-0439
Fax Number
985-725-1464
person
Provider Business Mailing Address Details
Address
12604 River Rd
City
State
Zip
70047-5306
Phone Number
985-764-0439
Fax Number
985-725-1464
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
(Louisiana)
Definition
Definition to come...
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