# CENLA FAMILY MEDICINE ASSOCIATES, LLC

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

## Provider details

- **NPI number:** 1538397542
- **Authorized official:** MR. MICHAEL J SCREPETIS MD (DESIGNATED REGISTERED AGENT)
- **Authorized official phone:** (318) 445-9823

## Contact information

- **Practice address:** 1587 N BOLTON AVE, SUITE 1100, ALEXANDRIA, LA 71303-4217
- **Practice address phone:** (318) 445-9823
- **Practice address fax:** (318) 445-1509
- **Mailing address:** P.O. BOX 5620, BELFAST, ME 04915-5600
- **Mailing address phone:** (318) 445-9823
- **Mailing address fax:** (318) 445-1509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 015029 | LA | — |
| 207Q00000X | Family Medicine Physician | 018528 | LA | Yes |
| 207Q00000X | Family Medicine Physician | 018963 | LA | — |
| 207R00000X | Internal Medicine Physician | 024254 | LA | — |
| 207RC0000X | Cardiovascular Disease Physician | 019187 | LA | — |
| 207RC0000X | Cardiovascular Disease Physician | 303310 | LA | — |
| 213E00000X | Podiatrist | 200010 | LA | — |
| 213E00000X | Podiatrist | PD20512 | LA | — |
| 363L00000X | Nurse Practitioner | AP01177 | LA | — |
| 363L00000X | Nurse Practitioner | AP0338 | LA | — |
| 363L00000X | Nurse Practitioner | AP06478 | LA | — |

## Other

- **Enumeration date:** 06/29/2009
- **Last updated:** 02/13/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1810886 | — | LA |