# C W KRIEGER JR A PROFESSIONAL MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1326210824
- **Authorized official:** DR. CHARLES W. KRIEGER JR. M.D. (PHYSICIAN/OWNER)
- **Authorized official phone:** (985) 646-3664

## Contact information

- **Practice address:** 1150 ROBERT BLVD, SUITE 190, SLIDELL, LA 70458-2004
- **Practice address phone:** (985) 646-3664
- **Practice address fax:** (985) 646-3683
- **Mailing address:** PO BOX 1819, SLIDELL, LA 70459-1819
- **Mailing address phone:** (985) 646-3664
- **Mailing address fax:** (985) 646-3683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 010738 | LA | Yes |

## Other

- **Enumeration date:** 03/25/2008
- **Last updated:** 07/07/2008