| NPI | 1992729560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL JOHNSON C.F.O. 225-237-1645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-10-24 |