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Organization

MYLAUREL MEDICAL GROUP LA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE BALDRIDGE (CREDENTIALING)
(702) 417-6255
Entity
Organization

Contact information

Practice address
1320 MAGAZINE ST STE 203, NEW ORLEANS, LA 70130-4267
(504) 475-1283
Mailing address
885 3RD AVE FL 29, NEW YORK, NY 10022-4834
(702) 417-6255

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
03/26/2018
Last updated
01/09/2024
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