Organization
ROLAND S. WAGUESPACK MD
Active
Other names
ST. PHILIP CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROLAND S WAGUESPACK M.D. (M.D.)
(225) 265-4087
Entity
Organization
Contact information
Practice address
1108 SAINT JAMES ST, VACHERIE, LA 70090-5320
(225) 265-4087
(225) 265-4006
Mailing address
1108 SAINT JAMES ST, VACHERIE, LA 70090-5320
(225) 265-4087
(225) 265-4006
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
009974
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1442224
—
LA
Enumeration date
05/10/2007
Last updated
08/22/2020
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