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Organization
PEDIATRIC GROUP OF ACADIANA, LLC
Active
Organization
PEDIATRIC GROUP OF ACADIANA, LLC
Active
Other names
St. Martinville Maternal-Child and Adult Clinic, St. Martinville Maternal-Child Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALEC MOYER (BUSINESS MANAGER)
(337) 256-5111
Entity
Organization
Contact information
Practice address
1119 N MAIN ST, SAINT MARTINVILLE, LA 70582-3513
(337) 394-7774
Mailing address
401 YOUNGSVILLE HWY STE 100, LAFAYETTE, LA 70508-5173
(337) 330-0031
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
10447R
LA
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/04/2008
Last updated
12/16/2019
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