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Organization
KENNETH P. MAUTERER MD A MEDICAL CORP
Active
Organization
KENNETH P. MAUTERER MD A MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH P MAUTERER MD (PRESIDENT)
(318) 495-3131
Entity
Organization
Contact information
Practice address
1148 N PINE ROAD, OLLA, LA 71465
(318) 495-3131
(318) 495-3677
Mailing address
PO BOX 668, OLLA, LA 71465-0668
(318) 495-3131
(318) 495-3677
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
012667
LA
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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