Organization
EDWIN URBI A MEDICAL LIMITED LIABILTY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY A. STEPHENS (CREDENTIALING/DELEGATE)
(318) 443-9339
Entity
Organization
Contact information
Practice address
5920 COLISEUM BLVD, ALEXANDRIA, LA 71303-3714
(318) 443-9339
(318) 443-9116
Mailing address
6221 GRAND OAK DR, ALEXANDRIA, LA 71301-2334
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1539368
—
LA
Enumeration date
02/06/2020
Last updated
02/06/2020
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