Provider Demographics
NPI:1114613171
Name:IN AND OUT PRIMARY CARE AND WELLNESS
Entity Type:Organization
Organization Name:IN AND OUT PRIMARY CARE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:504-323-5758
Mailing Address - Street 1:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-0667
Mailing Address - Country:US
Mailing Address - Phone:504-630-9641
Mailing Address - Fax:504-323-5758
Practice Address - Street 1:15814 PROFESSIONAL PLZ
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1453
Practice Address - Country:US
Practice Address - Phone:504-323-5758
Practice Address - Fax:504-323-5824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty