Organization
WASHINGTON PARISH EMERGENCY PHYSICIANS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY D. PROVOST (AUTHORIZED OFFICIAL)
(337) 534-0952
Entity
Organization
Contact information
Practice address
433 PLAZA ST, BOGALUSA, LA 70427-3729
(877) 485-4474
(405) 341-9217
Mailing address
PO BOX 720447, NORMAN, OK 73070-4328
(405) 240-9381
(405) 341-9217
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2425048
—
LA
Enumeration date
07/08/2016
Last updated
03/22/2022
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