Individual
SEAN MCDONOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7777 HENNESSY BLVD, SUITE 1008, CVT SURGICAL CENTER, BATON ROUGE, LA 70808-4537
(225) 766-0416
Mailing address
4262 JANET AVE APT 4, BATON ROUGE, LA 70808-4537
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
200711
LA
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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