Legacy Medical Group
LBN: Progressive Acute Care Physician Services Dauterive Llc
Legacy Medical Group is an health care organization with primary practice located at 1100 Andre St Suite 101, New Iberia LA 70563-2159. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Progressive Acute Care Physician Services Dauterive Llc can be contacted via phone (337) 369-9309, or through Thompson, Wayne D via phone (985) 624-7401.
Contact Information
Primary practice address
1100 Andre St Suite 101
New Iberia LA 70563-2159
Phone: (337) 369-9309
Fax: (337) 365-8455
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Surgery | 208600000X |
Profile Details
| NPI number | 1396911558 |
|---|---|
| LBN Legal business name | Progressive Acute Care Physician Services Dauterive Llc |
| DBA Doing business as | Legacy Medical Group |
| Authorized official | Thompson, Wayne D |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 7th, 2008 |
| Last updated | May 23rd, 2014 - about 12 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 | 1396911558 | NPPES |
| Louisiana | MEDICAID | 1321583 |
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Progressive Acute Care Physician Services , Llc
1100 Andre St Ste 101 , New Iberia LA 70563-2159