Individual
SCOTT F DIEDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1990 INDUSTRIAL BOULEVARD, HOUMA, LA 70363-7055
(985) 868-9300
(985) 851-0053
Mailing address
1990 INDUSTRIAL BOULEVARD, HOUMA, LA 71363-4176
(985) 868-9300
(985) 851-0053
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
A10602
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1624829
—
LA
Enumeration date
12/09/2005
Last updated
02/14/2008
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