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Organization
DRW
Active
Organization
DRW
Active
Other names
BAYOU FAMILY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTNEY WHITLOCK (CREDENTIALING MANAGER)
(318) 325-6200
Entity
Organization
Contact information
Practice address
832 JULIA ST, RAYVILLE, LA 71269-2608
(318) 728-4787
(318) 728-2598
Mailing address
PO BOX 15581, MONROE, LA 71207-5581
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/09/2020
Last updated
11/16/2020
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