Organization
WOMAN'S SPECIALTY CLINIC
Active
Other names
Woman's Specialty Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TERI G FONTENOT (CEO AND PRESIDENT)
(225) 927-1300
Entity
Organization
Contact information
Practice address
500 RUE DE LA VIE ST, SUITE 515, BATON ROUGE, LA 70817-5127
(225) 924-8550
(225) 924-8647
Mailing address
500 RUE DE LA VIE ST STE 311, BATON ROUGE, LA 70817-5128
(225) 924-8550
(225) 924-8647
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1444677
—
LA
Enumeration date
06/09/2006
Last updated
08/19/2022
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