Organization
ONE TELEMED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES EDWARDS (CHIEF EXECUTIVE OFFICER)
(337) 565-0843
Entity
Organization
Contact information
Practice address
1001 W PINHOOK ROAD, BUILDING 3 SUITE 219, LAFAYETTE, LA 70503
(337) 565-0843
(337) 205-4150
Mailing address
1001 W PINHOOK ROAD, BUILDING 3 SUITE 219, LAFAYETTE, LA 70503
(337) 565-0843
(337) 205-4150
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/28/2017
Last updated
08/28/2017
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