Organization
FMC ASSOCIATES OF NEW IBERIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE MATA M.D. (GENERAL PARTNER)
(337) 367-0271
Entity
Organization
Contact information
Practice address
2309 E MAIN ST, SUITE 400, NEW IBERIA, LA 70560-4046
(337) 367-0271
(337) 364-6139
Mailing address
2309 E MAIN ST, SUITE 400, NEW IBERIA, LA 70560-4046
(337) 367-0271
(337) 364-6139
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
015812
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1333093
—
LA
Enumeration date
06/08/2016
Last updated
06/08/2016
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