Organization
PRIMARY PHYSICIAN CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM CARL NABOURS MD (OWNER)
(337) 439-2020
Entity
Organization
Contact information
Practice address
631 S RYAN ST, LAKE CHARLES, LA 70601-5726
(337) 439-2020
(337) 439-2076
Mailing address
631 S RYAN ST, LAKE CHARLES, LA 70601-5726
(337) 439-2020
(337) 439-2076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14594
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1315966
—
LA
Enumeration date
02/10/2007
Last updated
07/08/2008
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