OrganizationActive
Destrehan Medical Clinic
NPI 1790876019 · Primary Care Clinic/Center · Destrehan, LA
Provider details
- NPI number
- 1790876019
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Chemmale Jayakrishnan, President/Doctor(985) 785-2045
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
12604 River Rd
Destrehan, LA 70047-5306
Phone: (985) 764-0439
Fax: (985) 725-1464
Approximate (ZIP-level) locationGet directions
Mailing address
12604 River Rd
Destrehan, LA 70047-5306
Registry dates
- Enumerated
- 2006-09-28
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.