Provider Demographics
NPI:1821095407
Name:INTERNAL MEDICINE CLINIC OF MORGAN CITY, LLC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE CLINIC OF MORGAN CITY, LLC
Other - Org Name:MEDICINE CLINIC OF MORGAN CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:METZ
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:985-702-8500
Mailing Address - Street 1:1126 MARGUERITE ST
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1854
Mailing Address - Country:US
Mailing Address - Phone:985-702-8500
Mailing Address - Fax:985-702-8507
Practice Address - Street 1:1126 MARGUERITE ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1854
Practice Address - Country:US
Practice Address - Phone:985-702-8500
Practice Address - Fax:985-702-8507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025614207Q00000X
LA025965207Q00000X
LA024948207R00000X
LA024914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1445606Medicaid
LA1445606Medicaid
LA1445606Medicaid