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Organization
CLINICS OF THE SOUTHEAST LLC
Active
Organization
CLINICS OF THE SOUTHEAST LLC
Active
Other names
Bogalusa Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY JUDE PALAZZO MD (CEO)
(985) 732-1568
Entity
Organization
Contact information
Practice address
405 AVENUE F, BOGALUSA, LA 70427-3633
(985) 732-1568
(985) 732-4458
Mailing address
PO BOX 370, BOGALUSA, LA 70429-0370
(985) 732-1568
(985) 732-4458
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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