Greenwell Medical Clinic LLC Dba North Point Family Health
Organization Active NPI Family Medicine Physician · Greenwell Springs, LA
NPI 1992896484 · NPPES record last updated Sep 4, 2014
Key facts
- NPI
- 1992896484
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 11621R (LA)
- Legal business name
- GREENWELL MEDICAL CLINIC LLC DBA NORTH POINT FAMILY HEALTH
- Practice address
- 18901 Greenwell Springs Rd
Greenwell Springs, LA 70739-4836 - Phone
- (225) 924-9985
- Fax
- (225) 924-0884
- NPI assigned
- Sep 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert Kyle Dean, MD
- Title
- Physician
- Phone
- (225) 924-9985
Practitioners 1
-
Frederick Erwin Hackley, M.D.
National Provider Directory
Locations
9985 Greenwell Springs Rd
Baton Rouge, LA 70814
Phone (225) 924-9985
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 11621R | LA | Yes |
| Family Medicine Physician |
207Q00000X | 05798R | LA | |
| General Practice Physician |
208D00000X | 10977 | LA |
Addresses
Primary practice location
18901 Greenwell Springs Rd
Greenwell Springs, LA 70739-4836
Mailing address
18901 Greenwell Springs Rd
Greenwell Springs, LA 70739-4836
Phone (225) 924-9985
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1695467 | Medicaid | LA | |
| 1103039 | Medicaid | LA | |
| 1321460 | Medicaid | LA |
Other providers in Greenwell Springs, LA
- Sharon R Fontenot
- Jovonda Fox
- Keiantia Franklin
- Dana A Galloway
- Carlita J Gordon
- Greenwell Springs Family Dentistry
- Sherry Clements Guidry
- Janice Hall
- Vernita Hardy
- Brianna Lashay Hawkins
All providers in Greenwell Springs, 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 Sep 4, 2014. 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.