Healthcare Provider Details

I. General information

NPI: 1437194883
Provider Name (Legal Business Name): WENDI DEFRANK, MD APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 RUE DE SANTE
LA PLACE LA
70068-5462
US

IV. Provider business mailing address

451 RUE DE SANTE
LA PLACE LA
70068-5462
US

V. Phone/Fax

Practice location:
  • Phone: 985-652-4400
  • Fax: 985-652-4490
Mailing address:
  • Phone: 985-652-4400
  • Fax: 985-652-4490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LISA M COWART
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 985-652-4400