Provider Demographics
NPI:1366001984
Name:DR DULAM HEALTH CARE CENTER
Entity Type:Organization
Organization Name:DR DULAM HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DULAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-304-9718
Mailing Address - Street 1:140 JEFFERSON DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5104
Mailing Address - Country:US
Mailing Address - Phone:601-304-9718
Mailing Address - Fax:601-304-9637
Practice Address - Street 1:904 FIRST ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71343-2108
Practice Address - Country:US
Practice Address - Phone:318-339-8387
Practice Address - Fax:318-339-6719
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR WILLIAM CONEY RURAL HEALTH CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service