Individual
ERIC AMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
703 E PRUDHOMME ST, OPELOUSAS, LA 70570-6494
(337) 942-7192
Mailing address
PO BOX 2118, OPELOUSAS, LA 70571-2118
(337) 942-7192
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
026562
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026562
STATE LICENSE
LA
Enumeration date
07/26/2006
Last updated
05/07/2015
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