Provider Demographics
NPI:1841479524
Name:FAMILY MEDICAL & SURGICAL CENTER OF MANY, APMC
Entity type:Organization
Organization Name:FAMILY MEDICAL & SURGICAL CENTER OF MANY, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:FOUNDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-256-2000
Mailing Address - Street 1:395 S CAPITOL ST
Mailing Address - Street 2:
Mailing Address - City:MANY
Mailing Address - State:LA
Mailing Address - Zip Code:71449-3049
Mailing Address - Country:US
Mailing Address - Phone:318-256-2000
Mailing Address - Fax:318-256-6237
Practice Address - Street 1:395 S CAPITOL ST
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449-3049
Practice Address - Country:US
Practice Address - Phone:318-256-2000
Practice Address - Fax:318-256-6237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CO89Medicare PIN