Organization
NORTHLAKE PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE ANTONIO LEFRAN MD (DOCTOR)
(985) 641-6454
Entity
Organization
Contact information
Practice address
951 GAUSE BLVD STE 2, SLIDELL, LA 70458-2937
(985) 641-6454
(985) 641-6458
Mailing address
951 GAUSE BLVD STE 2, SLIDELL, LA 70458-2937
(985) 641-6454
(985) 641-6458
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD11789R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14557
—
IA
Enumeration date
04/18/2007
Last updated
08/22/2020
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