Organization
MEDICAL PROFESSIONAL CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WADE DELAUGHTER JR. NP (OWNER)
(225) 954-5596
Entity
Organization
Contact information
Practice address
59215 RIVER WEST DR, PLAQUEMINE, LA 70764-6552
(225) 954-5596
Mailing address
8733 SIEGEN LN # 104, BATON ROUGE, LA 70810-1945
(225) 954-5596
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/09/2017
Last updated
10/04/2019
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