# ANNA FONTENOT MEDICAL CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Dupre Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164995742
- **Authorized official:** KELLI VIDRINE (BILLING MANAGER)
- **Authorized official phone:** (337) 363-5531

## Contact information

- **Practice address:** 1008 W MAIN ST, VILLE PLATTE, LA 70586-4208
- **Practice address phone:** (337) 363-5531
- **Mailing address:** 1008 W MAIN ST, VILLE PLATTE, LA 70586-4208
- **Mailing address phone:** (337) 363-5531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/07/2019
- **Last updated:** 01/19/2021