Omnicare Medical Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

202838 Issued in LA

Legal business name

OMNICARE MEDICAL CLINIC

Practice address

325 Liberty St
Houma, LA 70360-4425

Phone

(985) 879-3600

Fax

(985) 879-3605

NPI assigned

Jun 2, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Abayomi R Sanusi, MD

Title

President

Phone

(985) 879-3600

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1184850331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 981",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703610981",
            "telephone_number": "985-879-3600",
            "fax_number": "985-879-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 LIBERTY ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604425",
            "telephone_number": "985-879-3600",
            "fax_number": "985-879-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNICARE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "SANUSI",
        "authorized_official_first_name": "ABAYOMI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-879-3600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "202838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ochsner Clinic LLC
• Amanda Nicole Oden, MSW
• Adria Christine Odom
• Jessica Oliva, LCSW
• Katelyn Blanchard Olivier, FNP-C
• Sarah Oncale, DO
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• One Body LLC
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• Oph-Region 3-Nurse Family Partnership

• Internal Medicine Physician in Houma, LA
• Providers in Houma, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.