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Organization
ST. JAMES PRIMARY CARE, APMC
Active
Organization
ST. JAMES PRIMARY CARE, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANU PRASAD VELLANKI MD (DOCTOR)
(225) 869-9200
Entity
Organization
Contact information
Practice address
827 N PINE ST, GRAMERCY, LA 70052-3659
(225) 869-9200
Mailing address
PO BOX 419, GRAMERCY, LA 70052-0419
(225) 869-9200
(225) 869-9241
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1444111
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057843586A
BLUE CROSS BLUE SHIELD
LA
Enumeration date
10/25/2007
Last updated
06/29/2011
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