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Organization
DR. TINTIN DEVOE A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
DR. TINTIN DEVOE A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Mandeville Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALBERT DEVOE (BUSINESS MANAGER)
(985) 845-8894
Entity
Organization
Contact information
Practice address
4880 HIGHWAY 22, MANDEVILLE, LA 70471-6748
(985) 845-8894
(985) 845-1969
Mailing address
4880 HIGHWAY 22, MANDEVILLE, LA 70471-6748
(985) 845-8894
(985) 845-1969
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
016922
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0678432
AETNA
—
01
—
1200111
UNITEDHEALTH CARE
—
05
—
1326551
—
LA
05
—
1447048
—
LA
01
—
174540401769
HUMANA
—
01
—
26652840A
BLUE CROSS FEDERAL
—
01
—
4254173
AETNA
—
01
—
53252
BLUE CROSS / BLUE SHIELD
—
01
—
85720
COVENTRY HEALTH
—
Enumeration date
08/30/2006
Last updated
03/28/2008
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