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Organization

JEFFERSON PEDIATRIC CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTTY JAMES OUBRE (OFFICE ASSISTANT)
(504) 349-6813
Entity
Organization

Contact information

Practice address
1111 MEDICAL CENTER BLVD, SUITE N-813, MARRERO, LA 70072-3151
(504) 349-6813
(504) 349-6832
Mailing address
1111 MEDICAL CENTER BLVD, SUITE N-813, MARRERO, LA 70072-3151
(504) 349-6813
(504) 349-6832

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
06128R
LA

Other

Enumeration date
02/05/2007
Last updated
06/17/2008
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