Provider Demographics
NPI:1154512853
Name:WINNFIELD FAMILY PRACTICE, L.L.C
Entity Type:Organization
Organization Name:WINNFIELD FAMILY PRACTICE, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:RACHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-449-7821
Mailing Address - Street 1:427 W LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483-3463
Mailing Address - Country:US
Mailing Address - Phone:318-628-7374
Mailing Address - Fax:318-628-7301
Practice Address - Street 1:427 W LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483-3463
Practice Address - Country:US
Practice Address - Phone:318-628-7374
Practice Address - Fax:318-628-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.03803R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DG6589Medicare PIN
LA5DC23Medicare PIN