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Organization
ALLEGIANCE MEDICAL CLINIC OF DEQUINCY LLC
Active
Organization
ALLEGIANCE MEDICAL CLINIC OF DEQUINCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE MICHELLE WILLIS (CLINIC MANAGER)
(337) 786-1271
Entity
Organization
Contact information
Practice address
601 W 4TH ST, DEQUINCY, LA 70633-3301
(337) 786-6161
(337) 786-7999
Mailing address
601 W 4TH ST, DEQUINCY, LA 70633-3301
(337) 786-6161
(337) 786-7999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
NULL
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
02/08/2022
Last updated
09/19/2024
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