| NPI | 1265629166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN WAYNE GOODYEAR Medical Director 318-387-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: LA RN075367) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: LA RNO82557) |
| 207V00000X Obstetrics & Gynecology (Licence: LA MD.201086) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-10-03 |