Organization
YOUNGSVILLE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE RAFAEL BELGODERE-BONILLA (MD)
(337) 837-3615
Entity
Organization
Contact information
Practice address
811 ALBERTSON PKWY STE F, BROUSSARD, LA 70518-5256
(337) 837-3615
(337) 839-8097
Mailing address
811 ALBERTSON PKWY STE F, BROUSSARD, LA 70518-5256
(337) 837-3615
(337) 839-8097
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H3327
BLUE CROSS BLUE SHIELD
LA
Enumeration date
07/24/2006
Last updated
09/12/2022
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