| NPI | 1083935415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLYNN A TAYLOR Medical Physician 337-463-9890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: LA 014367) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2010-06-21 |