Individual
DR. EARLE WARD SUDDERTH,JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
920 HUEY P LONG AVE, GRETNA, LA 70053-6214
(504) 421-9654
(504) 366-0892
Mailing address
920 HUEY P LONG AVE, GRETNA, LA 70053-6214
(504) 421-9654
(504) 366-0892
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
009381
LA
Other
Enumeration date
02/01/2009
Last updated
02/01/2009
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