Organization
SLIDELL FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CUONG VAN LE M.D. (OWNER)
(985) 641-8191
Entity
Organization
Contact information
Practice address
1051 GAUSE BLVD, SUITE 380, SLIDELL, LA 70458-2951
(985) 641-8191
(985) 641-9812
Mailing address
PO BOX 160, SLIDELL, LA 70459-0160
(985) 641-8191
(985) 641-9812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD 06533R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1344346
—
LA
Enumeration date
12/04/2006
Last updated
08/22/2020
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