Healthcare Provider Details

I. General information

NPI: 1265653539
Provider Name (Legal Business Name): ROWLAND DUFFOUR CLINIC INC PMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 02/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 HWY 190 WEST
SLIDELL LA
70460
US

IV. Provider business mailing address

1400 HWY 190 WEST
SLIDELL LA
70460-5156
US

V. Phone/Fax

Practice location:
  • Phone: 985-646-1226
  • Fax:
Mailing address:
  • Phone: 985-646-1226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERYL LYNN ROWLAND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 985-646-1226