Organization
TECHE ACTION BOARD, INC.
Active
Other names
Teche Action Clinic @ Morgan City
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY M WILTZ MD (CEO)
(337) 828-2550
Entity
Organization
Contact information
Practice address
1124 7TH ST, MORGAN CITY, LA 70380-1951
(985) 384-2371
(985) 384-2645
Mailing address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 355-2335
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
04402470N
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2399560
—
LA
01
—
5B803
MEDICARE PART B
LA
Enumeration date
08/04/2015
Last updated
07/12/2023
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