NPI 1104872852

Classical Paediatrics, Amc

Organisation Specialist Monroe, LA

Practice location

Address: 920 Oliver Rd Suite 1475, Monroe, LA 71201-5702
Phone: (318) 323-3996
Fax: (318) 324-2181
Mailing address: 3928 Jefferson Davis Pl, Monroe, LA 71201-1957

Authorised official

Name: Martin Christian Young
Title: President
Phone: (318) 323-3996

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 09436R (LA)

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Registry record

NPI: 1104872852
Entity type: Organization
NPI issued: 25 May 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.