Provider Demographics
NPI:1083743876
Name:ST. FRANCIS MEDICAL CLINIC, LLC
Entity Type:Organization
Organization Name:ST. FRANCIS MEDICAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAYREE
Authorized Official - Middle Name:B
Authorized Official - Last Name:LATIOLAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-233-8887
Mailing Address - Street 1:501 W SAINT MARY BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4699
Mailing Address - Country:US
Mailing Address - Phone:337-233-8887
Mailing Address - Fax:337-233-4442
Practice Address - Street 1:501 W SAINT MARY BLVD STE 110
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4699
Practice Address - Country:US
Practice Address - Phone:337-233-8887
Practice Address - Fax:337-233-4442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty