Organization
THE PEDIATRIC PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY B BUSENLENER (MD)
(225) 636-5437
Entity
Organization
Contact information
Practice address
18135 E PETROLEUM DR, SUITE A, BATON ROUGE, LA 70809-6131
(225) 636-5437
(225) 636-5547
Mailing address
18135 E PETROLEUM DR, SUITE A, BATON ROUGE, LA 70809-6131
(225) 636-5437
(225) 636-5547
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/05/2012
Last updated
01/09/2013
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