Organization
CHARLES R GENOVESE JR MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES GENOVESE JR. (PRESIDENT)
(985) 878-4183
Entity
Organization
Contact information
Practice address
312 E RAIL ROAD AVE, INDEPENDENCE, LA 70443
(985) 878-4183
(985) 878-3830
Mailing address
PO BOX 969, INDEPENDENCE, LA 70443-0969
(985) 878-4183
(985) 878-3830
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
015669
LA
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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