Organization
DERMATOLOGY CLINIC A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
DERMATOLOGY CLINIC A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARRY A BURGLASS JR. MD (MD PRESIDENT)
(225) 769-7546
Entity
Organization
Contact information
Practice address
5326 O'DONOVAN DRIVE, BATON ROUGE, LA 70808-9153
(225) 769-7546
(225) 769-0471
Mailing address
5326 O'DONOVAN DRIVE, BATON ROUGE, LA 70808-9153
(225) 769-7546
(225) 769-0471
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1113247
—
LA
Enumeration date
10/11/2005
Last updated
04/04/2008
Update your record
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