# PELICAN PHYSICIAN SERVICES, LLC

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

## Provider details

- **NPI number:** 1851609978
- **Authorized official:** DR. KUMAR KISHORE AMARANENI M.D (OWNER/REGISTERED AGENT)
- **Authorized official phone:** (985) 645-9000

## Contact information

- **Practice address:** 2375 GAUSE BLVD E, SLIDELL, LA 70461-4142
- **Practice address phone:** (985) 645-9000
- **Practice address fax:** (985) 645-0359
- **Mailing address:** 2375 GAUSE BLVD E, SLIDELL, LA 70461-4142
- **Mailing address phone:** (985) 645-9000
- **Mailing address fax:** (985) 645-0359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 06512R | LA | Yes |
| 207Q00000X | Family Medicine Physician | 019740 | LA | — |
| 207R00000X | Internal Medicine Physician | 025659 | LA | — |
| 208000000X | Pediatrics Physician | 025659 | LA | — |

## Other

- **Enumeration date:** 09/23/2010
- **Last updated:** 07/09/2014