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Individual

DR. PAUL KRAY STAAB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5216 LAPALCO BLVD, MARRERO, LA 70072-4248
(985) 796-0904
(985) 796-0904
Mailing address
PO BOX 247, MARRERO, LA 70073-0247
(985) 796-0904
(985) 796-0904

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
017766
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1351768
LA
Enumeration date
06/25/2006
Last updated
07/08/2007
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