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Organization
FAMILY PRACTICE CENTER OF SULPHUR, LLC
Active
Organization
FAMILY PRACTICE CENTER OF SULPHUR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI FITKIN (CLINIC MANAGER)
(337) 625-0341
Entity
Organization
Contact information
Practice address
2509 MAPLEWOOD DR, SULPHUR, LA 70663-6105
(337) 625-0341
(337) 625-0347
Mailing address
2509 MAPLEWOOD DR, SULPHUR, LA 70663-6105
(337) 625-0341
(337) 625-0347
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1682969
—
LA
05
—
1684643
—
LA
Enumeration date
05/29/2007
Last updated
05/26/2020
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