Provider Demographics
NPI:1568753564
Name:LAWRENCE F. CHENIER, MD, A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:LAWRENCE F. CHENIER, MD, A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:F
Authorized Official - Last Name:CHENIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-574-5974
Mailing Address - Street 1:900 JOHNSON ST
Mailing Address - Street 2:P.O. BOX 8
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-4537
Mailing Address - Country:US
Mailing Address - Phone:318-574-5974
Mailing Address - Fax:318-574-5917
Practice Address - Street 1:900 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-4537
Practice Address - Country:US
Practice Address - Phone:318-574-5974
Practice Address - Fax:318-574-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015931282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1316288Medicaid
LAB60572Medicare UPIN
LA5J697Medicare PIN