Organization
VAN M ARDOIN, M.D., A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VAN M ARDOIN MD (OWNER)
(985) 876-6980
Entity
Organization
Contact information
Practice address
603 DUNN ST, HOUMA, LA 70360-4707
(985) 876-6980
(985) 876-6975
Mailing address
603 DUNN ST, HOUMA, LA 70360-4707
(985) 876-6980
(985) 876-6975
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
011488
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1146170
—
LA
Enumeration date
05/13/2008
Last updated
05/26/2010
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