West Jefferson Physician Services

NPI #1114092194 in Harvey, Louisiana

Provider Information

NPI Number: 1114092194
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: 2845 MANHATTAN BLVD
City: Harvey
State: Louisiana
ZIP Code: 70058-2987
Phone: (504) 349-6930

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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