Healthcare Provider Details

I. General information

NPI: 1891892147
Provider Name (Legal Business Name): CORNERSTONE PEDIATRICS,APMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 PARKWAY DR STE A
NATCHITOCHES LA
71457
US

IV. Provider business mailing address

1055 PARKWAY DR STE A P. O. BOX 7253
NATCHITOCHES LA
71457
US

V. Phone/Fax

Practice location:
  • Phone: 318-352-6464
  • Fax: 318-352-2488
Mailing address:
  • Phone: 318-352-6464
  • Fax: 318-352-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHRISTA JEAN PRADOS RODRIGUEZ
Title or Position: PRESIDENT/MD
Credential: MD
Phone: 318-352-6464