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Organization

ALLEGIANCE MEDICAL CLINIC OF DEQUINCY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RENEE MICHELLE WILLIS (CLINIC MANAGER)
(337) 786-1271
Entity
Organization

Contact information

Practice address
601 W 4TH ST, DEQUINCY, LA 70633-3301
(337) 786-6161
(337) 786-7999
Mailing address
601 W 4TH ST, DEQUINCY, LA 70633-3301
(337) 786-6161
(337) 786-7999

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician
213E00000X
Podiatrist
261QM1300X
Multi-Specialty Clinic/Center
261QR1300X
Rural Health Clinic/Center
Primary
363LP0200X
Pediatric Nurse Practitioner

Other

Enumeration date
02/08/2022
Last updated
09/19/2024
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