Organization
ALEXANDRIA NEUROSURGICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LAWRENCE DRERUP M.D. (PRESIDENT)
(318) 443-4576
Entity
Organization
Contact information
Practice address
3704 NORTH BLVD, SUITE C, ALEXANDRIA, LA 71301-3606
(318) 443-4576
(318) 449-5579
Mailing address
3704 NORTH BLVD, SUITE C, ALEXANDRIA, LA 71301-3606
(318) 443-4576
(318) 449-5579
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1792535
—
LA
Enumeration date
05/26/2006
Last updated
08/07/2014
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