Individual
DR. MARIE M ATTUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11990 JACKSON ST, CLINTON, LA 70722-3210
(225) 683-5292
(225) 683-3411
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-3411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14087R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1189405
—
LA
01
—
14087R
LA LICENSE
LA
Enumeration date
02/21/2007
Last updated
06/15/2016
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