MOREHOUSE PARISH HOSPITAL SERVICE DISTRICT 1 NPI 1891013496

NPI Information

NPI: 1891013496
Provider Name: MOREHOUSE PARISH HOSPITAL SERVICE DISTRICT 1

Doing Business As: MGH PHYSICIANS CLINIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
425 S VINE ST
BASTROP, LA
ZIP 71220
Phone: (318) 283-3960
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MOREHOUSE PARISH HOSPITAL SERVICE DISTRICT 1 is a multi-specialty clinic center in Bastrop, LA. MOREHOUSE PARISH HOSPITAL SERVICE DISTRICT 1 NPI is 1891013496. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mgh Physicians Clinic.

The provider's business location address is:

425 S VINE ST
BASTROP, LA
ZIP 71220-513
Phone: (318) 283-3960
Fax: (318) 239-8960

The provider's authorized official is Derrick Frazier .
The authorized official title is Ceo and has the following contact phone number (318) 283-3601.

The CLIA number assigned to this NPI record is 19D2130175 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/7/2010 and was last updated on 5/25/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207Q00000X	Family Medicine		No
2	207R00000X	Internal Medicine		No
3	207RG0100X	Internal Medicine	Gastroenterology	No
4	208600000X	Surgery		No
5	213ES0103X	Podiatrist	Foot & Ankle Surgery	No
6	363LF0000X	Nurse Practitioner	Family	No
7	363LN0000X	Nurse Practitioner	Neonatal	No
8	261QM1300X	Clinic/Center	Multi-Specialty	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2114646	MEDICAID	LOUISIANA

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: 5/5/2024

NPI Synchronization or Removal

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