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Individual

ETHEL MARIE MENDENHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
852 BELANGER ST, HOUMA, LA 70360-4408
(985) 872-1777
(985) 872-9777
Mailing address
852 BELANGER ST, HOUMA, LA 70360-4408
(985) 872-1777
(985) 872-9777

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
020636
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1966495
LA
Enumeration date
07/28/2006
Last updated
07/09/2007
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