Provider Demographics
NPI:1922163641
Name:ALAMMAR MEDICAL CLINIC
Entity Type:Organization
Organization Name:ALAMMAR MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALAMMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-238-5700
Mailing Address - Street 1:1760 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-5306
Mailing Address - Country:US
Mailing Address - Phone:337-238-5700
Mailing Address - Fax:337-238-5703
Practice Address - Street 1:1760 S 5TH ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-5306
Practice Address - Country:US
Practice Address - Phone:337-238-5700
Practice Address - Fax:337-238-5703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10433R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1447790Medicaid
LA1447790Medicaid
LA5CN89Medicare UPIN