| NPI | 1801895495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY CROCKETT WILEY Mso D Irector 337-392-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 207Y00000X Otolaryngology | |
| 208600000X Surgery | |
| 208800000X Urology | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2021-08-19 |