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Organization
WEST JEFFERSON SURGERY CENTER, LLC
Active
Organization
WEST JEFFERSON SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK JUNEAU M.D. (MEDICAL DIRECTOR)
(504) 349-2332
Entity
Organization
Contact information
Practice address
1111 MEDICAL CENTER BLVD, STE 105N, MARRERO, LA 70072-3152
(504) 349-2332
(504) 349-2359
Mailing address
1111 MEDICAL CENTER BLVD, SUITE 105 NORTH, MARRERO, LA 70072
(504) 349-2332
(504) 349-2359
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
115
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115
LIC NUMBER
LA
05
—
1150011
—
LA
Enumeration date
05/24/2005
Last updated
08/22/2020
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