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PELICAN CLINIC LLC NPI 1740553569


NPI Information

NPI: 1740553569
Provider Name: PELICAN CLINIC LLC
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
948 CAMBRIDGE DR STE 103B
LA PLACE, LA
ZIP 70068
Phone: (985) 652-7717
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PELICAN CLINIC LLC is an adult medicine family medicine in La Place, LA. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. PELICAN CLINIC LLC NPI is 1740553569. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

948 CAMBRIDGE DR STE 103B
LA PLACE, LA
ZIP 70068-647
Phone: (985) 652-7717
Fax: (337) 896-6441

The provider's authorized official is Letha Haynes .
The authorized official title is Owner and has the following contact phone number (954) 492-7150.

The enumeration date for this NPI number is 2/10/2012 and was last updated on 4/21/2023.


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
1207QA0505XFamily MedicineAdult Medicine27302LOUISIANAYes

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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