Organization
SURGEONCARE PHYSICIANS OF LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY ROBERTSON (CFO)
(336) 852-6525
Entity
Organization
Contact information
Practice address
1160 N PINE RD, OLLA, LA 71465
(318) 495-0760
(318) 495-0749
Mailing address
PO BOX 4207, MACON, GA 31208-4207
(318) 495-0760
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
03/23/2011
Last updated
04/07/2011
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