| NPI | 1578348397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER STOUT Manager 337-315-7927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 207R00000X Internal Medicine | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 208200000X Plastic Surgery | |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 2086S0127X Surgery, Trauma Surgery | |
| 2086S0129X | |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2025-02-11 |