Individual
JOSE R. ENRIQUEZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
508 BROADWAY ST, DELHI, LA 71232-3002
(318) 878-3737
(318) 878-8638
Mailing address
508 BROADWAY ST, DELHI, LA 71232-3002
(318) 878-3737
(318) 878-8638
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
07005R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07005R
LICENSE
LA
05
—
1359882
—
LA
Enumeration date
01/30/2006
Last updated
07/08/2007
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