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MANUEL MEDICAL CLINIC INC. NPI 1679620603


NPI Information

NPI: 1679620603
Provider Name: MANUEL MEDICAL CLINIC, INC.

Other Name: MANUEL MEDICAL CLINIC, INC. SITE 002

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
104 GENEVIEVE DR
LAFAYETTE, LA
ZIP 70503
Phone: (337) 984-0110
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MANUEL MEDICAL CLINIC, INC. is a pediatrics in Lafayette, LA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MANUEL MEDICAL CLINIC, INC. NPI is 1679620603. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Manuel Medical Clinic, Inc. Site 002.

The provider's business location address is:

104 GENEVIEVE DR
LAFAYETTE, LA
ZIP 70503-811
Phone: (337) 984-0110
Fax: (337) 981-7210

The provider's authorized official is Powlin V Manuel .
The authorized official title is President and has the following contact phone number (337) 984-0110.

The enumeration date for this NPI number is 1/4/2007 and was last updated on 4/21/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207K00000XAllergy & ImmunologyNo
2363LP0200XNurse PractitionerPediatricsAP05389LOUISIANANo
3363LP0200XNurse PractitionerPediatricsAP07960LOUISIANANo
4208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12138332MEDICAIDLOUISIANA
21171689MEDICAIDLOUISIANA
32381369MEDICAIDLOUISIANA
41033901MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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