Organization
PROGRESSIVE ACUTE CARE PHYSICIAN SERVICES DAUTERIVE LLC
Active
Other names
Legacy Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE D THOMPSON (CFO)
(985) 624-7401
Entity
Organization
Contact information
Practice address
1100 ANDRE ST, SUITE 101, NEW IBERIA, LA 70563-2159
(337) 369-9309
(337) 365-8455
Mailing address
PO BOX 11539, NEW IBERIA, LA 70562-1539
(337) 369-3481
(337) 365-8455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1321583
—
LA
Enumeration date
05/07/2008
Last updated
05/23/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us