Provider Demographics
NPI:1659566982
Name:FAMILY MEDICINE ASSOCIATES OF MINDEN, LLC
Entity Type:Organization
Organization Name:FAMILY MEDICINE ASSOCIATES OF MINDEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-866-3017
Mailing Address - Street 1:1111 HOMER RD
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3027
Mailing Address - Country:US
Mailing Address - Phone:318-377-7500
Mailing Address - Fax:
Practice Address - Street 1:1111 HOMER RD
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3027
Practice Address - Country:US
Practice Address - Phone:318-377-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health