Organization
WESTSIDE CLINICS ANC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVERY H SAMPSON MD (MANAGING PHYSICIAN & PRESIDENT)
(504) 391-7337
Entity
Organization
Contact information
Practice address
4225 LAPALCO BLVD, MARRERO, LA 70072
(504) 391-7337
(504) 398-7213
Mailing address
P O BOX 2400, MARRERO, LA 70073-2400
(504) 391-7337
(504) 398-7213
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1440574
—
LA
Enumeration date
08/10/2005
Last updated
06/26/2015
Update your record
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