Organization
SULPHUR PEDIATRIC CLINIC MEDICAL CORPORATION
Active
Other names
The Pediatric Center of SW LA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT W. RICHERT SR. M.D. (CO/OWNER)
(337) 527-6371
Entity
Organization
Contact information
Practice address
600 CYPRESS STREET, SULPHUR, LA 70663-5052
(337) 527-6371
(337) 528-9616
Mailing address
600 CYPRESS STREET, SULPHUR, LA 70663-5052
(337) 527-6371
(337) 528-9616
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
011494
LA
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1948195
—
LA
Enumeration date
05/20/2006
Last updated
05/18/2011
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