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Organization
MATTA MEDICAL CLINIC LLC
Active
Organization
MATTA MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUJATHA GUBBALA MD (MANAGER)
(318) 238-5990
Entity
Organization
Contact information
Practice address
647 BIENVILLE CIR, NATCHITOCHES, LA 71457-5744
(318) 238-5990
Mailing address
PO BOX 7111, NATCHITOCHES, LA 71457-0111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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