Organization
LA PETITE PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVA MARIE GUIDRY LEJEUNE MD (OWNER)
(337) 366-8616
Entity
Organization
Contact information
Practice address
200 BEAULLIEU DR STE 7, LAFAYETTE, LA 70508-7230
(337) 366-8616
(337) 366-8133
Mailing address
200 BEAULLIEU DR STE 7, LAFAYETTE, LA 70508-7230
(337) 366-8616
(337) 366-8133
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2116436
—
LA
05
—
2149270
—
LA
Enumeration date
09/19/2019
Last updated
04/14/2020
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