# LILY PAD PEDIATRICS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lily Pad Pediatrics, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073969531
- **Authorized official:** JACKIE CLARK (BILLING MANAGER)
- **Authorized official phone:** (337) 942-4453

## Contact information

- **Practice address:** 153 TOWN BOULEVARD, OPELOUSAS, LA 70570
- **Practice address phone:** (337) 942-4453
- **Mailing address:** 153 TOWN BOULEVARD, OPELOUSAS, LA 70570

## Taxonomy

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

## Other

- **Enumeration date:** 05/13/2016
- **Last updated:** 04/02/2024