# DANIELLE L MCLURKIN MD INC

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

## Provider details

- **NPI number:** 1932388576
- **Authorized official:** DR. DANIELLE LAVONNE MCLURKIN M.D. (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (337) 491-1009

## Contact information

- **Practice address:** 1403 OAK PARK BLVD, LAKE CHARLES, LA 70601-8847
- **Practice address phone:** (337) 491-1009
- **Practice address fax:** (337) 491-0602
- **Mailing address:** PO BOX 5420, LAKE CHARLES, LA 70606-5420
- **Mailing address phone:** (337) 491-1009
- **Mailing address fax:** (337) 491-0602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 15205R | LA | Yes |

## Other

- **Enumeration date:** 10/31/2007
- **Last updated:** 10/31/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1162965 | — | LA |
| 01 | — | 4F630CR38 | MEDICARE LINK NUMBER | LA |