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Organization
INTERNAL MEDICINE CLINIC OF TANGIPAHOA, LLC
Active
Organization
INTERNAL MEDICINE CLINIC OF TANGIPAHOA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS C STEVENS MD (PARTNER)
(985) 542-6251
Entity
Organization
Contact information
Practice address
42388 PELICAN PROFESSIONAL PARK, HAMMOND, LA 70403
(985) 542-6251
(985) 345-2386
Mailing address
PO BOX 1799, HAMMOND, LA 70404-1799
(985) 542-6251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RN0300X
Nephrology Physician
—
NULL
207RN0300X
Nephrology Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
07/28/2006
Last updated
08/23/2021
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