# CLINICS OF THE SOUTHEAST LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bogalusa Pediatric Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053979815
- **Authorized official:** DR. ANTHONY JUDE PALAZZO MD (CEO)
- **Authorized official phone:** (985) 732-1568

## Contact information

- **Practice address:** 405 AVENUE F, BOGALUSA, LA 70427-3633
- **Practice address phone:** (985) 732-1568
- **Practice address fax:** (985) 732-4458
- **Mailing address:** PO BOX 370, BOGALUSA, LA 70429-0370
- **Mailing address phone:** (985) 732-1568
- **Mailing address fax:** (985) 732-4458

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/05/2019
- **Last updated:** 06/05/2019