Organization
RALPH R NIX III LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH R NIX MD (OWNER)
(985) 626-8223
Entity
Organization
Contact information
Practice address
1580 W CAUSEWAY APPROACH, SUITE 3, MANDEVILLE, LA 70471-3033
(985) 626-8223
(985) 626-8253
Mailing address
PO BOX 9012, MANDEVILLE, LA 70470-9012
(985) 626-8223
(985) 626-8253
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
010588
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1148491
—
LA
01
—
5B936
MEDICARE GROUP NUMBER
LA
Enumeration date
03/23/2007
Last updated
01/28/2011
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