| NPI | 1578018479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J. DONOVAN Physician 337-239-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA AP08929) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: LA AP08929) |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2016-08-20 |