# MED-PEDS ASSOCIATES APMC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Susan F Ovella MD and Jacques L Guillot MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972513117
- **Authorized official:** MRS. JOE ANNE WELLS (MANAGER)
- **Authorized official phone:** (985) 845-0004

## Contact information

- **Practice address:** 804 HEAVENS DR, SUITE 106, MANDEVILLE, LA 70471
- **Practice address phone:** (985) 845-0004
- **Practice address fax:** (985) 845-0870
- **Mailing address:** 4700 LOUISIANA HWY 22, PMB 604, MANDEVILLE, LA 70471
- **Mailing address phone:** (985) 845-0004
- **Mailing address fax:** (985) 845-0870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 02/25/2008