Organization
CENLA FAMILY MEDICINE ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J SCREPETIS MD (DESIGNATED REGISTERED AGENT)
(318) 445-9823
Entity
Organization
Contact information
Practice address
1587 N BOLTON AVE, SUITE 1100, ALEXANDRIA, LA 71303-4217
(318) 445-9823
(318) 445-1509
Mailing address
P.O. BOX 5620, BELFAST, ME 04915-5600
(318) 445-9823
(318) 445-1509
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
015029
LA
207Q00000X
Family Medicine Physician
Primary
018528
LA
207Q00000X
Family Medicine Physician
018963
LA
207R00000X
Internal Medicine Physician
024254
LA
207RC0000X
Cardiovascular Disease Physician
019187
LA
207RC0000X
Cardiovascular Disease Physician
303310
LA
213E00000X
Podiatrist
200010
LA
213E00000X
Podiatrist
PD20512
LA
363L00000X
Nurse Practitioner
AP01177
LA
363L00000X
Nurse Practitioner
AP0338
LA
363L00000X
Nurse Practitioner
AP06478
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1810886
—
LA
Enumeration date
06/29/2009
Last updated
02/13/2017
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