# WALDHEIM FAMILY PRACTICE CLINIC

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

## Provider details

- **NPI number:** 1811183221
- **Authorized official:** DR. RICHARD J SANDERS JR. M.D. (PHYSICIAN)
- **Authorized official phone:** (985) 893-0486

## Contact information

- **Practice address:** 77173 HIGHWAY 21, COVINGTON, LA 70435-4011
- **Practice address phone:** (985) 893-0486
- **Practice address fax:** (985) 893-0349
- **Mailing address:** 77173 HIGHWAY 21, COVINGTON, LA 70435-4011
- **Mailing address phone:** (985) 893-0486
- **Mailing address fax:** (985) 893-0349

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 017339 | LA | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 09/19/2007