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Organization

NES LOUISIANA INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER MOORE (CFO)
(415) 435-4591
Entity
Organization

Contact information

Practice address
1900 MAIN ST, FRANKLINTON, LA 70438-3688
(985) 839-4431
Mailing address
PO BOX 402465, ATLANTA, GA 30384-2465
(304) 377-8721
(304) 697-1155

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08502898
MS
01
1900G6438Z
BCBS
LA
05
2142321
LA
01
DR4129
RR MEDICARE
Enumeration date
08/17/2010
Last updated
04/29/2013
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