Organization
MANUEL MEDICAL CLINIC, INC.
Active
Other names
Manuel Medical Clinic, Inc. site 002
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POWLIN V MANUEL MD (PRESIDENT)
(337) 984-0110
Entity
Organization
Contact information
Practice address
104 GENEVIEVE DR, LAFAYETTE, LA 70503-4811
(337) 984-0110
(337) 981-7210
Mailing address
104 GENEVIEVE DR, LAFAYETTE, LA 70503-4811
(337) 984-0110
(337) 981-7210
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
AP05389
LA
363LP0200X
Pediatric Nurse Practitioner
AP07960
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033901
—
LA
05
—
1171689
—
LA
05
—
2138332
—
LA
05
—
2381369
—
LA
Enumeration date
01/04/2007
Last updated
04/21/2020
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