Organization
CAVANAUGH FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY MILLETT CAVANAUGH M.D. (OWNER)
(337) 527-7087
Entity
Organization
Contact information
Practice address
1114 STELLY LN, SULPHUR, LA 70663-5139
(337) 527-7087
(337) 527-9831
Mailing address
1114 STELLY LN, SULPHUR, LA 70663-5139
(337) 527-7087
(337) 527-9831
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
203896
LA
Other
Enumeration date
11/15/2011
Last updated
11/15/2011
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