West Jefferson Physician Services
Organization Active NPI Family Medicine Physician · Lafitte, LA
NPI 1831266162 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1831266162
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- WEST JEFFERSON PHYSICIAN SERVICES
- Practice address
- 5140 Church St
Lafitte, LA 70067-5256 - Phone
- (504) 349-6525
- Fax
- (504) 349-6529
- NPI assigned
- Nov 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Heidi A Gwinn
- Title
- Credentialing Coord.
- Phone
- (504) 349-1297
Corporate family (same tax ID) 6
National Provider Directory
- Tax ID family
- Family Doctors
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
5140 Church St
Lafitte, LA 70067-5256
Mailing address
5140 Church St
Lafitte, LA 70067-5256
Phone (504) 349-6525
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942545 | Medicaid | LA |
Other names
- Family Doctors
Other providers in Lafitte, LA
- Quynh T Lu-Lewis
- Courtney Leigh Pellegrin
- Elizabeth Ponder
- Tewelde'S Lafitte Drugs
- Tewelde'S Lafitte Drugs 2, Inc.
All providers in Lafitte, LA · Family Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.