Divine Health Primary Care Clinic, Llc

  • 1548528854 NPI Number
  • |
  • Actived: 12 years ago
  • |
Divine Health Primary Care Clinic, Llc is a health care provider based in Ruston, LA. The NPI Number is 1548528854 and it has been active since 12 years ago. The specialty is Internal Medicine, providing comprehensive mental health services to individuals, families, and communities. If you are looking for Internal Medicine services, Divine Health Primary Care Clinic, Llc is an excellent option. We are here to help you get the care you need.

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Overview of Divine Health Primary Care Clinic, Llc

  • NPI number: 1558967950
  • Provider type: Organization
  • Active since: 04/25/2012
  • Last updated: 04/25/2012

Primary Scrop of Practice

  • Taxonomy Code: 207R00000X
  • Specialty: Internal Medicine
  • License Number: 203609
  • License State: LA

Provider Mailing Address

  • Address: 1401 Ezell Street
    Ruston, LA 71270
  • Phone: 318-259-1204
  • Fax: 318-259-1255

Provider Practice Location

  • Address: 1401 Ezell Street
    Ruston, LA 71270
  • Phone: 318-259-1204
  • Fax: 318-259-1255

Authorized Official

  • Name: DR. Ofundem Rose Gwan M.D.
  • Position/Title: Owner/physician
  • Telephone Number: 318-259-1204

Scope of Practice

  • Taxonomy Code: 207R00000X
  • Specialty: Internal Medicine
  • License Number: 203609
  • License State: LA
  • Switch: Yes

Legacy Identifiers

  • Provider Identifier: 1245440940
  • Identifier Type: Other
  • Identifier State: LA
  • Issuer: INDIVIDUAL NPI

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for Divine Health Primary Care Clinic, Llc?
  • A: The npi number for Divine Health Primary Care Clinic, Llc is 1548528854.
  • Q: What are Divine Health Primary Care Clinic, Llc's specialties?
  • A: Divine Health Primary Care Clinic, Llc's specialties are Internal Medicine and different specialities.
  • Q: Where is Divine Health Primary Care Clinic, Llc business practice location?
  • A: Divine Health Primary Care Clinic, Llc business practice location is 1401 Ezell Street, Ruston, LA 71270.
  • Q: How to contact Divine Health Primary Care Clinic, Llc?
  • A: You can contact Divine Health Primary Care Clinic, Llc via 318-259-1204.
  • Q: What is the authorized official for Divine Health Primary Care Clinic, Llc?
  • A: The authorized office name is DR. Ofundem Rose Gwan M.D. with position/title is Owner/physician and you can reach the authorized official via phone number 3182591204.
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