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Contact Information

CAPITAL CITY MEDICAL GROUP, LLC
120 MEADOWCREST ST
SUITE 120
GRETNA, LA70056-5255
 Phone: 504-620-5661
 Fax: 504-620-5674
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Rheumatology

207RR0500X 11 Physician/Internal Medicine
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for CAPITAL CITY MEDICAL GROUP LLC · (Female)

NPI # 1487084943
Status Active
Credentials
Entity Individual
Enumeration date 11/20/2013
Last updated 05/12/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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