Provider Demographics
NPI:1083956841
Name:WEEMS, RIKKI DARCEY
Entity Type:Individual
Prefix:
First Name:RIKKI
Middle Name:DARCEY
Last Name:WEEMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RIKKI
Other - Middle Name:LYNN
Other - Last Name:DARCEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 54482
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70154-4482
Mailing Address - Country:US
Mailing Address - Phone:985-898-4493
Mailing Address - Fax:
Practice Address - Street 1:1202 S TYLER ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-2330
Practice Address - Country:US
Practice Address - Phone:985-898-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207763207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2329952Medicaid