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PROGRESSIVE ACUTE CARE PHYSICIAN SERVICES DAUTERIVE LLC NPI 1396911558


NPI Information

NPI: 1396911558
Provider Name: PROGRESSIVE ACUTE CARE PHYSICIAN SERVICES DAUTERIVE LLC

Doing Business As: LEGACY MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1100 ANDRE ST
SUITE 101
NEW IBERIA, LA
ZIP 70563
Phone: (337) 369-9309
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PROGRESSIVE ACUTE CARE PHYSICIAN SERVICES DAUTERIVE LLC is a family medicine in New Iberia, LA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROGRESSIVE ACUTE CARE PHYSICIAN SERVICES DAUTERIVE LLC NPI is 1396911558. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Legacy Medical Group.

The provider's business location address is:

1100 ANDRE ST
SUITE 101
NEW IBERIA, LA
ZIP 70563-159
Phone: (337) 369-9309
Fax: (337) 365-8455

The provider's authorized official is Wayne D Thompson .
The authorized official title is Cfo and has the following contact phone number (985) 624-7401.

The enumeration date for this NPI number is 5/7/2008 and was last updated on 5/23/2014.


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 License Number License State Primary
1208600000XSurgeryNo
2207Q00000XFamily MedicineYes

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
15DE05MEDICARE PINLOUISIANA
21321583MEDICAIDLOUISIANA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.