Provider Demographics
NPI:1033400452
Name:NES CENTRAL LOUISIANA, INC.
Entity Type:Organization
Organization Name:NES CENTRAL LOUISIANA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-242-6711
Mailing Address - Street 1:PO BOX 504764
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-4764
Mailing Address - Country:US
Mailing Address - Phone:800-377-8721
Mailing Address - Fax:304-697-1155
Practice Address - Street 1:4231 HIGHWAY 1192
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-4711
Practice Address - Country:US
Practice Address - Phone:318-253-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2152327Medicaid
LA2152327Medicaid