Organization
ASCENSION MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA LAVERGNE (CREDENTIALING SPECIALIST)
(225) 953-7388
Entity
Organization
Contact information
Practice address
37325 MARKET PLACE DR., SUITE D, PRAIRIEVILLE, LA 70769
(225) 953-7388
(225) 953-7389
Mailing address
37325 MARKET PLACE DR STE D, PRAIRIEVILLE, LA 70769-3499
(225) 953-7388
(225) 953-7389
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
204876
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538182118
NPPES
LA
Enumeration date
08/23/2017
Last updated
07/21/2022
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