Organization
WESTERN LOUISIANA INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEMANT PANDE M.D. (PRESIDENT)
(337) 239-4130
Entity
Organization
Contact information
Practice address
1015 W FERTITTA BLVD, LEESVILLE, LA 71446-4646
(337) 239-4130
(337) 238-4104
Mailing address
1015 W FERTITTA BLVD, LEESVILLE, LA 71446-4646
(337) 239-4130
(337) 238-4104
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14565R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1127647
—
LA
01
—
14565R
LA. STATE LICENSE #
LA
Enumeration date
01/09/2006
Last updated
08/09/2007
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