Organization
GULFSOUTH PULMONOLOGY, LLC
Active
Parent organization
GULFSOUTH PULMONARY, LLC
Other names
dba - GulfSouth Pulmonary, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GULFSOUTH PULMONARY, LLC
Authorized official
BRANDI OGDEN (BILLING / CREDENTIALING MANAGER)
(985) 400-5988
Entity
Organization
Contact information
Practice address
1970 N HWY 190, COVINGTON, LA 70433
(985) 400-5988
(985) 867-3644
Mailing address
PO BOX 3370, COVINGTON, LA 70434-3370
(985) 400-5988
(985) 867-3644
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
04/06/2018
Last updated
09/06/2018
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