Organization
CHILDREN'S KIDMED CLINIC INC.
Active
Organization
CHILDREN'S KIDMED CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALLISON AMY (PRESIDENT)
(337) 942-5633
Entity
Organization
Contact information
Practice address
1200 HOSPITAL DR, SUITE 8, OPELOUSAS, LA 70570-6552
(337) 942-5633
Mailing address
1200 HOSPITAL DR, SUITE 8, OPELOUSAS, LA 70570-6552
(337) 942-5633
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1416363
—
LA
Enumeration date
02/21/2007
Last updated
08/22/2020
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