Organization
PATRICK C HAGEN EAR, NOSE, THROAT & SINUS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CELESTE PONVELLE (ADMINISTRATOR)
(800) 639-2519
Entity
Organization
Contact information
Practice address
2000 AUDUBON AVE, SUITE C, THIBODAUX, LA 70301-5075
(985) 446-1200
Mailing address
PO BOX 146, THIBODAUX, LA 70302-0146
(800) 639-2519
(985) 447-8556
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
02/01/2007
Last updated
07/07/2014
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