Organization
LAFAYETTE HEALTH VENTURES INC
Active
Other names
dba Family Health Plaza
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KIRK (VICE PRESIDENT)
(337) 289-8951
Entity
Organization
Contact information
Practice address
1216 CAMELLIA BLVD, LAFAYETTE, LA 70508-6667
(337) 769-0069
(337) 769-0068
Mailing address
1216 CAMELLIA BLVD, LAFAYETTE, LA 70508-6667
(337) 769-0069
(337) 769-0068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447251
—
LA
01
—
CG2600
RAILROAD
LA
Enumeration date
07/03/2006
Last updated
04/15/2013
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