Provider Demographics
NPI:1821355264
Name:MINDEN PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:MINDEN PHYSICIAN PRACTICES LLC
Other - Org Name:STELL FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESS
Authorized Official - Middle Name:N
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-8500
Mailing Address - Street 1:102 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3086
Mailing Address - Country:US
Mailing Address - Phone:318-377-2885
Mailing Address - Fax:318-377-2886
Practice Address - Street 1:102 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3086
Practice Address - Country:US
Practice Address - Phone:318-377-2885
Practice Address - Fax:318-377-2886
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINDEN PHYSICIAN PRACTICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health