Organization
DELUXE MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERTRAND TILLERY JR. MD (PHYSICIAN)
(504) 418-5226
Entity
Organization
Contact information
Practice address
3640 LAKE ASPEN DR W, GRETNA, LA 70056-8303
(504) 418-4226
(504) 365-9902
Mailing address
3640 LAKE ASPEN DR W, GRETNA, LA 70056-8303
(504) 418-4226
(504) 365-9902
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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