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Contact Information

INTERNAL MEDICINE CLINIC OF TANGIPAHOA, LLC
42388 PELICAN PROFESSIONAL PARK
HAMMOND, LA70403
 Phone: 985-542-6251
 Fax: 985-345-2386
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Nephrology

207RN0300X 11 Physician/Internal Medicine
 

Podiatrist

213E00000X 48 Podiatry
 

Primary Care

363LP2300X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for INTERNAL MEDICINE CLINIC OF TANGIPAHOA LLC · (Female)

NPI Number 1588678494
Status Active
Credentials
Entity Individual
Enumeration date 07/28/2006
Last updated 08/23/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • LA Medicaid 1442933
  • LA Other 5CB03 GROUP NUMBER
  • LA Other 19D0997591 MAIN LAB CLIA #
  • LA Other 10664-EQT2 PODIATRY X-RAY REG #
  • LA Other 10664-EQT1 X-RAY REG #
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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