Organization
JULIO E. IGLESIAS,M.D. A PROFESSIONAL MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIO E IGLESIAS M.D. (PRESIDENT/M.D.)
(318) 628-2108
Entity
Organization
Contact information
Practice address
301 W BOUNDARY AVE, SUITE A, WINNFIELD, LA 71483-3427
(318) 628-2108
(318) 628-6211
Mailing address
301 W BOUNDARY AVE, SUITE A, WINNFIELD, LA 71483-3427
(318) 628-2108
(318) 628-6211
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
05638R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02000158
MC UNITED HEALTHCARE
GA
01
—
1205213510
BLUE CROSS OF LOUISIANA
LA
05
—
1317519
—
LA
Enumeration date
04/01/2008
Last updated
01/05/2010
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