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1497702880
STACY D CONVILLE
RUSTON, LA
NPI
1497702880
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 026106)
Enumeration Date
2006-05-30
Last Update Date
2014-03-17
Business Address
Dr. STACY D CONVILLE MD
1809 NORTHPOINT LANE SUITE 102
RUSTON, LA 71270
Phone number: 318-251-8232
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Mailing Address
Dr. STACY D CONVILLE MD
401 E VAUGHN AVE
RUSTON, LA 71270-5950
Phone number: 318-251-8232
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