# FAMILY PRACTICE ASSOCIATES

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

## Provider details

- **NPI number:** 1982685293
- **Authorized official:** KATHY ROBERTSON (OFFICE MANAGER)
- **Authorized official phone:** (318) 445-6363

## Contact information

- **Practice address:** 65 MEDICAL PARK BLVD, SUITE 104, PINEVILLE, LA 71360-8428
- **Practice address phone:** (318) 445-6363
- **Practice address fax:** (318) 445-1663
- **Mailing address:** 65 MEDICAL PARK BLVD, SUITE 104, PINEVILLE, LA 71360-8428
- **Mailing address phone:** (318) 445-6363
- **Mailing address fax:** (318) 445-1663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2005
- **Last updated:** 10/12/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1440876 | — | LA |
| 01 | — | CK2896 | RAILROAD MEDICARE | LA |