Organization
ST. JAMES PRIMARY CARE, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANU PRASAD VELLANKI MD (DOCTOR)
(225) 869-9200
Entity
Organization
Contact information
Practice address
827 N PINE ST, GRAMERCY, LA 70052-3659
(225) 869-9200
Mailing address
PO BOX 419, GRAMERCY, LA 70052-0419
(225) 869-9200
(225) 869-9241
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1444111
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057843586A
BLUE CROSS BLUE SHIELD
LA
Enumeration date
10/25/2007
Last updated
06/29/2011
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