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Organization
KELLY G BURKENSTOCK MD A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
KELLY G BURKENSTOCK MD A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY G BURKENSTOCK M.D. (PRESIDENT)
(985) 727-7676
Entity
Organization
Contact information
Practice address
2040 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-3116
(985) 727-7676
(985) 727-3476
Mailing address
2040 N CAUSEWAY BLVD, MANDEVILLE, LA 70471-3116
(985) 727-7676
(985) 727-3476
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.023319
LA
Other
Enumeration date
09/16/2008
Last updated
07/19/2022
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