Stephens Johnny J Member
LBN: Pride Plaza Medical Llc
Stephens Johnny J Member is an health care organization with primary practice located at 850 N Pierce Street Suite D, Lafayette LA 70501-2848. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Pride Plaza Medical Llc can be contacted via phone (337) 233-2115, or through Mwatibo, James Mwakitawa via phone (337) 233-2115.
Contact Information
Primary practice address
850 N Pierce Street Suite D
Lafayette LA 70501-2848
Phone: (337) 233-2115
Fax: (337) 237-9075
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X |
Profile Details
| NPI number | 1790773430 |
|---|---|
| LBN Legal business name | Pride Plaza Medical Llc |
| DBA Doing business as | Stephens Johnny J Member |
| Authorized official | Mwatibo, James Mwakitawa MD, PHD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 6th, 2005 |
| Last updated | Oct 7th, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790773430 | NPPES |
| Louisiana | MEDICAID | 1443522 |
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