Provider Demographics
NPI:1972033504
Name:PROFICIENT MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:PROFICIENT MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-261-2633
Mailing Address - Street 1:2701 JOHNSTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3263
Mailing Address - Country:US
Mailing Address - Phone:337-261-2633
Mailing Address - Fax:337-261-2633
Practice Address - Street 1:2701 JOHNSTON ST STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3263
Practice Address - Country:US
Practice Address - Phone:337-261-2633
Practice Address - Fax:337-261-3766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty