Organization
SOUTHSIDE FAMILY CLINIC LLC
Active
Other names
Delcambre Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DIES (PRESIDENT)
(337) 580-4061
Entity
Organization
Contact information
Practice address
506 W HIGHWAY 14, DELCAMBRE, LA 70528-2308
(337) 685-2020
Mailing address
506 W HIGHWAY 14, DELCAMBRE, LA 70528-2308
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/15/2020
Last updated
03/14/2022
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