Conville, Stacy D
Conville, Stacy D is an sole proprietor health care provider with primary practice located at 1809 Northpoint Lane Suite 102, Ruston LA 71270. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Conville, Stacy D can be contacted via phone (318) 251-8232.Contact Information
Primary practice address
1809 Northpoint Lane Suite 102
Ruston LA 71270
Phone: (318) 251-8232
Fax: (318) 251-8255
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 026106 | Louisiana |
Profile Details
| NPI number | 1497702880 |
|---|---|
| LBN Legal business name | Conville, Stacy D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 30th, 2006 |
| Last updated | Mar 17th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497702880 | NPPES |
| Louisiana | MEDICAID | 1052931 |
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