Organization
WEST JEFFERSON PHYSICIAN SERVICES
Active
Other names
Family Doctors
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI A GWINN (CREDENTIALING COORD.)
(504) 349-1297
Entity
Organization
Contact information
Practice address
5140 CHURCH ST, LAFITTE, LA 70067-5256
(504) 349-6525
(504) 349-6529
Mailing address
5140 CHURCH ST, LAFITTE, LA 70067-5256
(504) 349-6525
(504) 349-6529
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942545
—
LA
Enumeration date
11/30/2006
Last updated
08/22/2020
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