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Organization

MAGNOLIA PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA HAMNER (OFFICE MANAGER)
(225) 744-4484
Entity
Organization

Contact information

Practice address
17038 COMMERCE CENTRE DR, PRAIRIEVILLE, LA 70769-3483
(225) 744-4484
(225) 677-9359
Mailing address
17038 COMMERCE CENTRE DR, PRAIRIEVILLE, LA 70769-3483
(225) 744-4484
(225) 677-9359

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
045939
LA

Other

Enumeration date
12/04/2006
Last updated
11/06/2018
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