Individual
DR. RANDALL KENNETH LILLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8166 MAIN ST, HOUMA, LA 70360-3404
(800) 456-9121
(214) 712-2487
Mailing address
5 BOURG CT, HARAHAN, LA 70123-4422
(504) 738-5851
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
014665
LA
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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