| NPI | 1356192652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES EUGENE WILLIAMSON Owner 504-434-9164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-12-30 |