| NPI | 1679815294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JOSPEH DONOVAN Owner/Pysician 337-239-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD203745) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2016-10-25 |