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Organization
SOUTHSIDE FAMILY CLINIC LLC
Active
Organization
SOUTHSIDE FAMILY CLINIC LLC
Active
Other names
Delcambre Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DIES (PRESIDENT)
(337) 580-4061
Entity
Organization
Contact information
Practice address
506 W HIGHWAY 14, DELCAMBRE, LA 70528-2308
(337) 685-2020
Mailing address
506 W HIGHWAY 14, DELCAMBRE, LA 70528-2308
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/15/2020
Last updated
03/14/2022
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