Organization
RONALD J. KLUCHIN, M.D.,A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD JOHN KLUCHIN M.D. (OWNER/INTERNAL MEDICINE)
(985) 626-8110
Entity
Organization
Contact information
Practice address
784 ASBURY DR, MANDEVILLE, LA 70471-1844
(985) 626-8110
(985) 626-8423
Mailing address
784 ASBURY DR, MANDEVILLE, LA 70471-1844
(985) 626-8110
(985) 626-8423
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
017699
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386057
—
LA
Enumeration date
08/06/2012
Last updated
01/27/2016
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