Organization
WK RUSTON PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE WARD (SR. VP FINANCE)
(318) 716-4939
Entity
Organization
Contact information
Practice address
931 N TRENTON ST, RUSTON, LA 71270-3327
(318) 497-7750
(318) 467-7757
Mailing address
931 N TRENTON ST, RUSTON, LA 71270-3327
(318) 497-7750
(318) 467-7757
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
11/13/2023
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