Organization
CONSERVATIVE MEDICAL MANAGEMENT A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITZIE B DUHON (OFFICE MANAGER)
(337) 269-6335
Entity
Organization
Contact information
Practice address
1103 KALISTE SALOOM RD, SUITE 202, LAFAYETTE, LA 70508-5783
(337) 269-6335
(337) 235-2765
Mailing address
1103 KALISTE SALOOM RD, SUITE 202, LAFAYETTE, LA 70508-5783
(337) 269-6335
(337) 235-2765
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
L10009R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1979732
—
LA
Enumeration date
04/08/2008
Last updated
12/09/2009
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