Organization
TAMELA L MARCA CHARBONNET MD/LEE H GRAFTON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN BOURGEDIS (OFFICE MANAGER)
(985) 876-5000
Entity
Organization
Contact information
Practice address
GRAFTON DERM AND COSMETIC SURGERY, 327 BAYOU GARDENS BLVD, HOUMA, LA 70360
(985) 876-5000
(985) 876-5280
Mailing address
GRAFTON DERM AND COSMETIC SURGERY, 327 BAYOU GARDENS BLVD, HOUMA, LA 70360
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
023735
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1441953
—
LA
05
—
1484768
—
LA
05
—
1687421
—
LA
01
—
1932412
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/21/2006
Last updated
08/22/2020
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