Organization
PELICAN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETHA HAYNES (OWNER)
(954) 492-7150
Entity
Organization
Contact information
Practice address
948 CAMBRIDGE DR STE 103B, LA PLACE, LA 70068-3647
(985) 652-7717
(337) 896-6441
Mailing address
948 CAMBRIDGE DR STE 103B, LA PLACE, LA 70068-3647
(985) 652-7717
(985) 618-3611
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
27302
LA
Other
Enumeration date
02/10/2012
Last updated
04/21/2023
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