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Organization
SLIDELL INTERNAL MEDICINE CLINIC LLC
Active
Organization
SLIDELL INTERNAL MEDICINE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLAN QUIBILAN LARCENA MD (OWNER)
(985) 646-0123
Entity
Organization
Contact information
Practice address
105 MEDICAL CENTER DR, SUITE 301, SLIDELL, LA 70461-5544
(985) 646-0123
(985) 641-0330
Mailing address
105 MEDICAL CENTER DR, SUITE 301, SLIDELL, LA 70461-5544
(985) 646-0123
(985) 641-0330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11339R
LA
Other
Enumeration date
05/09/2007
Last updated
12/28/2007
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