Individual
DENISE GOODFELLOW KERUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9605 JEFFERSON HIGHWAY, RIVER RIDGE, LA 70123
(504) 738-1604
(504) 738-7860
Mailing address
9605 JEFFERSON HIGHWAY, RIVER RIDGE, LA 70123
(504) 738-1604
(504) 738-7860
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
09413R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2392531
—
LA
Enumeration date
11/12/2014
Last updated
05/18/2018
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