Individual
DR. JEFFREY JOHN COMBETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2104 LOOP RD, SUITE C, WINNSBORO, LA 71295-3338
(318) 435-4571
(318) 435-7458
Mailing address
2104 LOOP RD, SUITE C, WINNSBORO, LA 71295-3338
(318) 435-4571
(318) 435-7458
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
203014
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12125071
CAQH
—
05
—
1501174
—
LA
01
—
MD.203014
LICENSE
LA
Enumeration date
03/07/2007
Last updated
12/22/2020
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