Organization
ACCESS HEALTH LOUISIANA
Active
Other names
St Charles CHC - 1057 Paul Maillard
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KEISER (PRESIDENT)
(504) 575-3700
Entity
Organization
Contact information
Practice address
1057 PAUL MAILLARD RD, SUITE 240, LULING, LA 70070-4349
(985) 785-2045
(504) 575-3691
Mailing address
2900 INDIANA AVE, KENNER, LA 70065-4605
(504) 575-3712
(504) 575-3691
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD.04201R
LA
207RN0300X
Nephrology Physician
MD.03945R
LA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2384457
—
LA
Enumeration date
07/31/2014
Last updated
08/08/2016
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