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Organization

PEPA WOUND CARE SPECIALISTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH HODGE MD (OWNER)
(504) 906-1641
Entity
Organization

Contact information

Practice address
7301 HENNESSY BLVD STE 103, BATON ROUGE, LA 70808-4794
(225) 765-4286
(225) 765-5976
Mailing address
PO BOX 721464, NORMAN, OK 73070-8128
(877) 485-4474

Taxonomy

Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2435604
LA
Enumeration date
07/11/2016
Last updated
09/17/2019
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