Organization
WEST JEFFERSON PHYSICIAN SERVICES
Active
Other names
Family Doctors
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI A GWINN (CREDENTIALING COORD.)
(504) 349-1297
Entity
Organization
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE S850, MARRERO, LA 70072-3151
(504) 349-6450
(504) 349-6454
Mailing address
1111 MEDICAL CENTER BLVD, SUITE S850, MARRERO, LA 70072-3151
(504) 349-6450
(504) 349-6454
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942545
—
LA
Enumeration date
11/22/2006
Last updated
08/22/2020
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