Provider Demographics
NPI:1801010426
Name:WOODLAWN FAMILY HEALTH, LLC
Entity Type:Organization
Organization Name:WOODLAWN FAMILY HEALTH, LLC
Other - Org Name:WOODLAWN FAMILY HEALTH LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER OF CLINIC
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-756-4100
Mailing Address - Street 1:5428 STUMBERG LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816
Mailing Address - Country:US
Mailing Address - Phone:225-756-4100
Mailing Address - Fax:225-756-4106
Practice Address - Street 1:5428 STUMBERG LN
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816
Practice Address - Country:US
Practice Address - Phone:225-756-4100
Practice Address - Fax:225-756-4106
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOODLAWN FAMILY HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-13
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty