Divine Health Primary Care Clinic, LLC
NPI 1548528854 · Internal Medicine Physician · Ruston, LA
Divine Health Primary Care Clinic, LLC is a Internal Medicine Physician organization in Ruston, LA (NPI 1548528854).
Provider details
- NPI number
- 1548528854
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ofundem Gwan, Owner/Physician(318) 259-1204
- License
- 203609 (LA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Divine Health and Primary Care Clinic
Registry dates
- Enumerated
- 2012-04-25
- Last updated
- 2012-04-25
Frequently asked questions
- What is Divine Health Primary Care Clinic, LLC's NPI number?
- Divine Health Primary Care Clinic, LLC's National Provider Identifier (NPI) is 1548528854, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Divine Health Primary Care Clinic, LLC?
- Divine Health Primary Care Clinic, LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Divine Health Primary Care Clinic, LLC located?
- Divine Health Primary Care Clinic, LLC's practice location on file with NPPES is 1401 Ezell Street, Ruston, LA 71270-7218.
- What is Divine Health Primary Care Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Divine Health Primary Care Clinic, LLC is (318) 259-1204.
- Who is the authorized official for Divine Health Primary Care Clinic, LLC?
- The authorized official listed on Divine Health Primary Care Clinic, LLC's NPPES record is Ofundem Gwan, Owner/Physician. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Divine Health Primary Care Clinic, LLC's NPI active?
- Yes — Divine Health Primary Care Clinic, LLC's NPI (1548528854) is active in the NPPES registry as of the last update on 2012-04-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.