Organization
SOUTHERN PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STELLA IMMANUEL M.D. (OWNER)
(318) 730-9760
Entity
Organization
Contact information
Practice address
1416 METRO DR, ALEXANDRIA, LA 71301-3424
(318) 561-4200
(318) 561-4205
Mailing address
5910 DUBLIN RD, ALEXANDRIA, LA 71303-5234
(318) 561-4200
(318) 561-4205
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1449237
—
LA
Enumeration date
08/31/2006
Last updated
11/03/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us