Provider Demographics
NPI:1952175770
Name:ACCESS PRIMARY CARE LLC
Entity Type:Organization
Organization Name:ACCESS PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:BERNAUER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:337-794-1227
Mailing Address - Street 1:2825 COUNTRY CLUB RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5915
Mailing Address - Country:US
Mailing Address - Phone:337-444-5867
Mailing Address - Fax:
Practice Address - Street 1:2825 COUNTRY CLUB RD STE A
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5915
Practice Address - Country:US
Practice Address - Phone:337-444-5867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty