Organization
ORTHOPAEDIC RECONSTRUCTIVE SUB-SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL E FENN JR. MD (SOLE MEMBER)
(337) 534-0653
Entity
Organization
Contact information
Practice address
301 RUE BEAUREGARD, SUITE C, LAFAYETTE, LA 70508-8520
(337) 534-0653
Mailing address
301 RUE BEAUREGARD, SUITE C, LAFAYETTE, LA 70508-8520
(337) 534-0653
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
MD.200825
LA
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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