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Dr. Gary Birdsall Medical Clinic Llc

Dr. Gary Birdsall Medical Clinic Llc is a health care provider in Cut Off, LA. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 102 W 112th St, Cut Off, LA 70345-3628, US
Practice Location Phone985-632-5222
Practice Location Fax985-632-4222
Legal Business NameDR. GARY BIRDSALL MEDICAL CLINIC LLC
NPI ?1245667823
Entity TypeOrganization
Enumeration Date ? Sep 27, 2013
Last Update Date ? Mar 21, 2014
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Dr. Gary Birdsall Medical Clinic Llc

SpecialtySpecializationLicenseLicense State
Family Medicine

legacy-id-icon Legacy Provider IDs of Dr. Gary Birdsall Medical Clinic Llc

Provider IdIssuer StateIssuer TypeIssuer
1366145LouisianaMedicaid

official-icon Authorized Official of Dr. Gary Birdsall Medical Clinic Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Dr. Gary Birdsall Medical Clinic Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Gary Birdsall (MD)
Authorized Official Title/PositionMD/OWNER
Authorized Official Phone Number985-632-5222