# NWABUEZE NNAMDI INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EAST FELICIANA PRIMARY CARE CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114047735
- **Authorized official:** DR. STACIE N NWABUEZE PH.D (ADMINISTRATOR)
- **Authorized official phone:** (225) 634-3517

## Contact information

- **Practice address:** 3050 CHARLES DR, JACKSON, LA 70748-6135
- **Practice address phone:** (225) 634-3517
- **Practice address fax:** (225) 635-5057
- **Mailing address:** 3050 CHARLES DR, JACKSON, LA 70748-6135
- **Mailing address phone:** (225) 634-3517
- **Mailing address fax:** (225) 635-5057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | L12712R | LA | Yes |
| 208D00000X | General Practice Physician | L12712R | LA | — |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 07/06/2015