NPI | 1942629589 |
---|---|
Doing Business As | AZALEA MEDICAL CLINIC |
Entity Type | Organization |
Authorized Contact | KATHARINE J. ROSE President 504-434-2330 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 201310) |
Additional Taxonomies | 251T00000X PACE Provider Organization (Licence: FL 201310) |
Enumeration Date | 2014-04-10 |
Last Update Date | 2019-02-28 |