Organization
WOODWORTH FAMILY MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID VANMOL (PRESIDENT)
(318) 484-9588
Entity
Organization
Contact information
Practice address
9372 HWY.165 SOUTH, WOODWORTH, LA 71485
(318) 484-9588
(318) 484-9590
Mailing address
P.O.BOX406, WOODWORTH, LA 71485
(318) 484-9588
(318) 484-9590
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
119
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1494437
—
LA
Enumeration date
10/18/2007
Last updated
10/18/2007
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