Organization
FAMILY PRACTICE CENTER OF SULPHUR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI FITKIN (CLINIC MANAGER)
(337) 625-0341
Entity
Organization
Contact information
Practice address
2509 MAPLEWOOD DR, SULPHUR, LA 70663-6105
(337) 625-0341
(337) 625-0347
Mailing address
2509 MAPLEWOOD DR, SULPHUR, LA 70663-6105
(337) 625-0341
(337) 625-0347
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1682969
—
LA
05
—
1684643
—
LA
Enumeration date
05/29/2007
Last updated
05/26/2020
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