Provider Demographics
NPI:1679745798
Name:CLAUDE B MINOR JR APMC
Entity type:Organization
Organization Name:CLAUDE B MINOR JR APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:BARRETT
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:318-388-2996
Mailing Address - Street 1:2806 MARK DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5152
Mailing Address - Country:US
Mailing Address - Phone:318-388-2996
Mailing Address - Fax:318-388-2998
Practice Address - Street 1:2806 MARK DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5152
Practice Address - Country:US
Practice Address - Phone:318-388-2996
Practice Address - Fax:318-388-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017426174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA57888Medicare PIN