Organization
NEW HAVEN FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY KEHINDE ADEOSUN MD (OWNER)
(337) 493-8480
Entity
Organization
Contact information
Practice address
333 S RYAN ST, SUITE 120, LAKE CHARLES, LA 70601-5821
(337) 493-8480
Mailing address
333 S RYAN ST, SUITE 120, LAKE CHARLES, LA 70601-5821
(337) 493-8480
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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