Organization
INTERNAL MEDICINE CLINIC OF HOUMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL PATRICK HENRY M.D. (OWNER)
(985) 876-7388
Entity
Organization
Contact information
Practice address
911 VERRET ST, HOUMA, LA 70360-4637
(985) 876-7388
Mailing address
911 VERRET ST, HOUMA, LA 70360-4637
(985) 876-7388
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1796395
—
LA
Enumeration date
10/27/2006
Last updated
07/21/2022
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