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Organization

LEWIS AVENUE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SAMUEL D HUCKABEE (CEO)
(318) 469-1132
Entity
Organization

Contact information

Practice address
600 N LEWIS ST, NEW IBERIA, LA 70563-2043
(337) 374-4111
Mailing address
PO BOX 721931, NORMAN, OK 73070-8473
(318) 253-8611

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
05/08/2015
Last updated
05/13/2015
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