# MINDEN INTERNAL MEDICINE & PEDIATRICS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154300275
- **Authorized official:** DR. KELLY M CARLISLE MD (OWNER)
- **Authorized official phone:** (318) 377-2979

## Contact information

- **Practice address:** 101 OFFICE PARK DR, MINDEN, LA 71055-3088
- **Practice address phone:** (318) 377-2979
- **Practice address fax:** (318) 377-2596
- **Mailing address:** 101 OFFICE PARK DR, MINDEN, LA 71055-3088
- **Mailing address phone:** (318) 377-2979
- **Mailing address fax:** (318) 377-2596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | LA | Yes |

## Other

- **Enumeration date:** 01/17/2006
- **Last updated:** 04/20/2008