# MILLENNIUM NEONATOLOGY OF LOUISIANA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MILLENNIUM MEDICAL GROUP PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811643232
- **Legal business name:** MILLENNIUM MEDICAL GROUP PLLC
- **Authorized official:** EMILY RATTRAY (MANAGER)
- **Authorized official phone:** (552) 229-6378

## Contact information

- **Practice address:** 1900 W GAUTHIER RD, LAKE CHARLES, LA 70605-7170
- **Practice address phone:** (855) 222-9637
- **Mailing address:** PO BOX 20236, BEAUMONT, TX 77720-0236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2022
- **Last updated:** 07/21/2022