Organization
IBERIA FOOT SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN BLAKE GREEN D.P.M. (OWNER)
(337) 364-8878
Entity
Organization
Contact information
Practice address
2309 E MAIN ST, SUITE 201, NEW IBERIA, LA 70560-4046
(337) 364-8878
(337) 364-8380
Mailing address
2309 E MAIN ST, SUITE 201, NEW IBERIA, LA 70560-4046
(337) 364-8878
(337) 364-8380
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
PD324R
LA
Other
Enumeration date
09/20/2006
Last updated
08/22/2020
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