SOUTH LOUISIANA PRIMARY CARE LLC NPI 1447705074

NPI Information

  • NPI: 1447705074
  • Provider Name: SOUTH LOUISIANA PRIMARY CARE LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 19D2132966
  • Address: 12902 PLANK RD
    BAKER, LA
    ZIP 70714
  • Phone: (225) 218-4816

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NPI Details

SOUTH LOUISIANA PRIMARY CARE LLC is a family medicine in Baker, 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. SOUTH LOUISIANA PRIMARY CARE LLC NPI is 1447705074. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12902 PLANK RD
BAKER, LA
ZIP 70714-911
Phone: (225) 218-4816
Fax: (225) 302-5057

The provider's authorized official is Dustin Allen Logue .
The authorized official title is Owner and has the following contact phone number (225) 774-0733.

The CLIA number assigned to this NPI record is 19D2132966 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2016 and was last updated on 7/8/2024.

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
1207Q00000XFamily MedicineYes
2261QP2300XClinic/CenterPrimary CareAP06078LOUISIANANo

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
12110691MEDICAIDLOUISIANA

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: 11/21/2025

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