Organization
JEFFERSON FAMILY MEDICAL CENTER ,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN ALLAN HEISE M.D. (PRESIDENT)
(225) 926-4780
Entity
Organization
Contact information
Practice address
330 LEE DR., SUITE B, BATON ROUGE, LA 70808-1601
(225) 926-4780
(225) 926-4783
Mailing address
330 LEE DR., SUITE B, BATON ROUGE, LA 70808-1601
(225) 926-4780
(225) 926-4783
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
12387R
LA
Other
Enumeration date
09/27/2006
Last updated
08/22/2020
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