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Organization
FAMILY PRACTICE ASSOCIATES
Active
Organization
FAMILY PRACTICE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY ROBERTSON (OFFICE MANAGER)
(318) 445-6363
Entity
Organization
Contact information
Practice address
65 MEDICAL PARK BLVD, SUITE 104, PINEVILLE, LA 71360-8428
(318) 445-6363
(318) 445-1663
Mailing address
65 MEDICAL PARK BLVD, SUITE 104, PINEVILLE, LA 71360-8428
(318) 445-6363
(318) 445-1663
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
—
1440876
—
LA
01
—
CK2896
RAILROAD MEDICARE
LA
Enumeration date
11/14/2005
Last updated
10/12/2007
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