Organization
JEFFERSON COMMUNITY HEALTH CARE CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS STACEY MARIE LOVELL (BILLING OFFICE/CREDENTIALING)
(504) 436-2223
Entity
Organization
Contact information
Practice address
4028 HIGHWAY 90 W, AVONDALE, LA 70094-2622
(504) 436-2223
(504) 436-2224
Mailing address
4028 HIGHWAY 90 W, AVONDALE, LA 70094-2622
(504) 436-2223
(504) 436-2224
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447196
—
LA
Enumeration date
11/18/2005
Last updated
08/22/2020
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