Organization
WEST JEFFERSON PHYSICIAN SERVICES
Active
Other names
Family Doctors
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI A GWINN (CREDENTIALING COORDINATOR)
(504) 349-1297
Entity
Organization
Contact information
Practice address
175 HECTOR AVE, GRETNA, LA 70056-2590
(504) 349-6925
(504) 361-5310
Mailing address
175 HECTOR AVE, GRETNA, LA 70056-2590
(504) 349-6925
(504) 361-5310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942545
—
LA
Enumeration date
11/22/2006
Last updated
09/11/2025
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