# ASCENSION MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104084938
- **Authorized official:** DR. STEVEN L HOLMES M.D. (GENERAL PRACTIONER)
- **Authorized official phone:** (225) 647-6636

## Contact information

- **Practice address:** 214 S BURNSIDE AVE STE A, GONZALES, LA 70737-3463
- **Practice address phone:** (225) 647-6636
- **Practice address fax:** (225) 647-3849
- **Mailing address:** 214 S BURNSIDE AVE STE A, GONZALES, LA 70737-3463
- **Mailing address phone:** (225) 647-6636
- **Mailing address fax:** (225) 647-3849

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | MD09828R | LA | Yes |

## Other

- **Enumeration date:** 05/29/2008
- **Last updated:** 05/29/2008