Individual
DR. KELLY LANIER PAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ESPLANADE AVE, KENNER, LA 70065-2489
(504) 443-9500
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
308434
LA
208VP0014X
Interventional Pain Medicine Physician
308434
LA
Other
Enumeration date
04/23/2014
Last updated
08/05/2019
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