Provider Demographics
NPI:1972517746
Name:HOUMA ORTHOPEDIC CLINIC AMC
Entity type:Organization
Organization Name:HOUMA ORTHOPEDIC CLINIC AMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:ALLEMAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-857-9790
Mailing Address - Street 1:1001 SCHOOL STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4691
Mailing Address - Country:US
Mailing Address - Phone:985-857-9790
Mailing Address - Fax:985-873-2968
Practice Address - Street 1:1001 SCHOOL STREET
Practice Address - Street 2:SUITE B
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4691
Practice Address - Country:US
Practice Address - Phone:985-857-9790
Practice Address - Fax:985-873-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C447Medicare PIN