Healthcare Provider Details

I. General information

NPI: 1821430869
Provider Name (Legal Business Name): WEST FELICIANA PARISH HOSPITAL PEDIATRIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10273 GOULD DRIVE 650
SAINT FRANCISVILLE LA
70775-1219
US

IV. Provider business mailing address

PO BOX 1219
SAINT FRANCISVILLE LA
70775-1219
US

V. Phone/Fax

Practice location:
  • Phone: 225-635-9065
  • Fax: 225-635-9069
Mailing address:
  • Phone: 225-635-9065
  • Fax: 225-635-9069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. LADOUX J CHASTANT III
Title or Position: CEO
Credential:
Phone: 225-635-3811