| NPI | 1124270749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO P HEBERT Manager 985-446-2131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: LA 09201R) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2025-04-03 |