Provider Demographics
NPI:1942215546
Name:KERRY M SCHEXNAIDER INTERNAL MEDICINE GROUP LLC
Entity Type:Organization
Organization Name:KERRY M SCHEXNAIDER INTERNAL MEDICINE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHEXNAIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-893-8490
Mailing Address - Street 1:PO BOX 847
Mailing Address - Street 2:
Mailing Address - City:MAURICE
Mailing Address - State:LA
Mailing Address - Zip Code:70555-0847
Mailing Address - Country:US
Mailing Address - Phone:337-893-8490
Mailing Address - Fax:337-893-4090
Practice Address - Street 1:207 MILTON RD
Practice Address - Street 2:
Practice Address - City:MAURICE
Practice Address - State:LA
Practice Address - Zip Code:70555-4448
Practice Address - Country:US
Practice Address - Phone:337-893-8490
Practice Address - Fax:337-893-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CU99Medicare PIN