Alexandria Womens Center a Medical

Organization Active NPI Obstetrics Physician · Alexandria, LA

NPI 1295872992 · NPPES record last updated Oct 10, 2019

Key facts

NPI
1295872992
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics Physician 207VX0000X
Legal business name
ALEXANDRIA WOMENS CENTER A MEDICAL
Practice address
3304 Masonic Drive
Suite 4001
Alexandria, LA 71301-9998
Phone
(318) 443-7222
Fax
(318) 443-7641
NPI assigned
Jan 31, 2007
Organization subpart
No

Authorized official

Name
Dr. Glenn Richard Aucoin, M.D.
Title
Vice President/Treasurer
Phone
(318) 443-7222

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040505000954 LA Part B Supplier - Clinic/Group Practice 4880682061 Receives reassigned benefits from 6 practitioners
Practice locations: Alexandria, LA

National Provider Directory

Locations

3311 Prescott Rd
Ste 401
Alexandria, LA 71301
Phone (318) 443-7222

3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917

3304 Masonic Dr
Ste 4001
Alexandria, LA 71301
Phone (318) 443-7222

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207VX0000X Yes

Addresses

Primary practice location

3304 Masonic Drive
Suite 4001
Alexandria, LA 71301-9998

Mailing address

P.O. Box 13318
Suite 410
Alexandria, LA 71315-9998
Phone (318) 443-7222

Other identifiers

IdentifierTypeStateIssuer
1917664MedicaidLA
1489301MedicaidLA
1492183MedicaidLA
1363961MedicaidLA

Other providers in Alexandria, LA

All providers in Alexandria, LA · Obstetrics Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.