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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

NPI # 1588678494
LBN Legal business name INTERNAL MEDICINE CLINIC OF TANGIPAHOA, LLC
Authorized official NICHOLAS STEVENS - (PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/28/2006
Last updated 08/23/2021 - About 5 years ago
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 #
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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