Organization
CALCASIEU FAMILY PHYSICIANS, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY M FUQUA M.D. (PHYSICIAN)
(337) 527-6530
Entity
Organization
Contact information
Practice address
920 1ST AVE, SULPHUR, LA 70663-3425
(337) 527-6530
(337) 527-7337
Mailing address
920 1ST AVE, SULPHUR, LA 70663-3425
(337) 527-6530
(337) 527-7337
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD200962
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1072907
—
LA
01
—
1861667297
NPI
—
Enumeration date
05/06/2009
Last updated
05/06/2009
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