Organization
PREMIER MEDICAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY MARK B. AMIGO MD (PHYSICIAN)
(318) 253-5647
Entity
Organization
Contact information
Practice address
338 MOREAU ST, MARKSVILLE, LA 71351-2956
(318) 253-5647
Mailing address
338 MOREAU ST, MARKSVILLE, LA 71351-2956
(318) 253-5647
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
11268R
LA
Other
Enumeration date
07/01/2006
Last updated
08/22/2020
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