Organization
LAKESIDE WOMEN'S SPECIALTY CENTER, APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN G WILD M.D. (PRESIDENT)
(504) 885-8563
Entity
Organization
Contact information
Practice address
4315 HOUMA BLVD, SUITE 500, METAIRIE, LA 70006-2940
(504) 885-8563
(504) 455-1072
Mailing address
4315 HOUMA BLVD, SUITE 500, METAIRIE, LA 70006-2940
(504) 885-8563
(504) 455-1072
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942561
—
LA
Enumeration date
10/18/2006
Last updated
08/22/2020
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