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Organization

SOUTHSIDE FAMILY CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN DIES FNP-C (PRESIDENT)
(337) 580-4061
Entity
Organization

Contact information

Practice address
304 N HOSPITAL DR STE A, ABBEVILLE, LA 70510-4041
(337) 580-4061
Mailing address
304 N HOSPITAL DR STE A, ABBEVILLE, LA 70510-4041
(337) 385-1972
(337) 385-2849

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
261QR1300X
Rural Health Clinic/Center
Primary

Other

Enumeration date
06/20/2017
Last updated
04/28/2018
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