Organization
GULFSOUTH CRITICAL CARE LLC
Active
Organization
GULFSOUTH CRITICAL CARE LLC
Active
Other names
GulfSouth Critical Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI WILLIS-OGDEN (BILLING / CREDENTIALING MANAGER)
(985) 400-5988
Entity
Organization
Contact information
Practice address
1970 N HIGHWAY 190, COVINGTON, LA 70433-5364
(985) 400-5988
(985) 867-3644
Mailing address
PO BOX 3370, COVINGTON, LA 70434
(985) 400-5988
(985) 867-3644
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/23/2018
Last updated
03/23/2018
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