Provider Demographics
NPI:1245429273
Name:SPRINGER FAMILY MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:SPRINGER FAMILY MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-436-1370
Mailing Address - Street 1:601 DR. MICHEAL DEBAKEY DR.
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5815
Mailing Address - Country:US
Mailing Address - Phone:337-436-1370
Mailing Address - Fax:337-436-1621
Practice Address - Street 1:601 DR. MICHEAL DEBAKEY
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5815
Practice Address - Country:US
Practice Address - Phone:337-436-1370
Practice Address - Fax:337-436-1621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023883174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1487414Medicaid
LA5CF97OtherMEDICARE GROUP
LA436596843BOtherBLUE CROSS IND.
LA5A676OtherMEDICARE IND
LA5CF97OtherMEDICARE GROUP