Organization
CCP MEDICAL MANAGEMENT LLC
Active
Other names
Phipps Management LLC MBR
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GROVER PHIPPS (MANAGER)
(337) 896-6400
Entity
Organization
Contact information
Practice address
213 FOURPARK RD, SUITE C, LAFAYETTE, LA 70507-2481
(337) 896-6440
(337) 896-6441
Mailing address
213 FOURPARK RD, SUITE C, LAFAYETTE, LA 70507-2481
(337) 896-6400
(337) 896-6441
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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