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Organization

LANNAN FAMILY PRACTICE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAUREEN ROSE LANNAN M.D. (OWNER)
(337) 527-2491
Entity
Organization

Contact information

Practice address
622 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-2491
(337) 528-2749
Mailing address
5204 LAPAIX DR, SULPHUR, LA 70663-9369
(337) 527-2491
(337) 528-2749

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10386R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1999857
LA
01
436895832C
BLUE CROSS BLUE SHIELD LA
LA
Enumeration date
03/22/2007
Last updated
03/20/2008
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