Provider Demographics
NPI:1902201379
Name:HAWKEYE MEDICAL URGENT CARE,LLC
Entity Type:Organization
Organization Name:HAWKEYE MEDICAL URGENT CARE,LLC
Other - Org Name:HAWKEYE FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PLAUCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-253-7023
Mailing Address - Street 1:597 TUNICA DR. W
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351
Mailing Address - Country:US
Mailing Address - Phone:318-253-7023
Mailing Address - Fax:318-253-0864
Practice Address - Street 1:597 TUNICA DR. W.
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351
Practice Address - Country:US
Practice Address - Phone:318-253-7023
Practice Address - Fax:318-253-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty