Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Destrehan Medical Clinic

Organization Primary Care Clinic/Center · NPI 1790876019

Destrehan Medical Clinic is a Primary Care Clinic/Center in Destrehan, Louisiana. Licensed in Louisiana. Registered with an NPI since 2006.

Licensed in
LA
In the registry since
2006

Practice location Address checks out

12604 River Rd
Destrehan, LA 70047-5306
Phone: (985) 764-0439
Fax: (985) 725-1464
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X (LA)

Record details

NPI number1790876019
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chemmale Jayakrishnan — President/Doctor · (985) 785-2045
NPI enumeratedSeptember 28, 2006
Last updated in NPPESJuly 21, 2022
Mailing address12604 River Rd, Destrehan, LA 70047-5306

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