| NPI | 1669648564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL SELLERS CFO 225-381-2755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-07-23 |