HOME PHYSICIANS 2011, PC
Medical Practice at Saint Charles Ave, New Orleans, LA

License number
Louisiana 060011234
Category
Medical Practice
Type
Case Manager/Care Coordinator
Owner
Name: DR. DIRK O WALES M.D.
Title: CEO/OWNER
Phone: (615) 564-3511
Address
Address 2
201 Saint Charles Ave SUITE 2562A, New Orleans, LA 70170
1340 S Damen Ave SUITE 400, Chicago, IL 60608
National Provider ID: 1831572171
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HOME PHYSICIANS 2011 P.C., PROFESSIONAL CORPORATION

Chicago, IL  -  Franklin, TN  -  Miami, FL

Doing business as:
Home Physician 2011 P.C., Corporation
Registration:
Jul 16, 2013
Addresses:
1340 S Damen Ave, Chicago, IL 60608 (Physical)
9009 Carothers Pkwy SUITE 501, Franklin, TN 37067 (Mailing)
9100 S Dadeland Blvd, Miami, FL 33156
State ID:
41232163F
Business type:
Business Corporation (Non-Louisiana)
Directors:
Kiran Srirama, M.d (President, Secretary, Treasurer, Director), 1340 S Damen Ave, Chicago, IL 60608 (Physical),Wales Dirk (President, Secretary),Michael Fessenden Chairman, Director, President, Secretary, Treasurer, inactive,...
Agent:
Corporation Service Company,320 Somerulos St, Baton Rouge, LA 70802 (Physical)

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