West Jefferson Physician Services

NPI #1053486043 in Marrero, Louisiana

Provider Information

NPI Number: 1053486043
Entity Type: Organization
Organization Name: West Jefferson Physician Services
Primary Specialty: Internal Medicine
Enumeration Date: Nov 22, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1111 MEDICAL CENTER BLVD
Address 2: SUITE S850
City: Marrero
State: Louisiana
ZIP Code: 70072-3151
Phone: (504) 349-6450

Authorized Official

Name: HEIDI A GWINN
Title: CREDENTIALING COORD.
Phone: (504) 349-1297

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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