Organization
ORTHO CLINIC - PROFESSIONAL MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD J LISECKI M.D., (PHYSICIAN)
(337) 364-5310
Entity
Organization
Contact information
Practice address
516 JEFFERSON TERRRACE BLVD, SUITE 100, NEW IBERIA, LA 70560-4948
(337) 364-5310
(337) 364-5313
Mailing address
516 JEFFERSON TER, SUITE 100, NEW IBERIA, LA 70560-4980
(337) 364-5310
(337) 364-5313
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
26008
LA
Other
Enumeration date
02/07/2007
Last updated
01/16/2013
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