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Organization
SOUTHERN LOUISIANA MEDICAL GROUP, LLC
Active
Organization
SOUTHERN LOUISIANA MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN DRAKE (GENERAL MANAGER)
(504) 229-7451
Entity
Organization
Contact information
Practice address
2104 GAUSE BLVD W STE A, SLIDELL, LA 70460-4130
(985) 643-4575
(833) 222-4520
Mailing address
PO BOX 7462, SLIDELL, LA 70469-7462
(985) 643-4575
(833) 222-4520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
10/09/2020
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