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General NPI Number Information
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NPI Number | 1114020542
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Entity Type | Organization
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Legal Business Name | VILLE PLATTE PEDIATRICS PA
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 504 JACK MILLER ROAD SUITE 3
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City | VILLE PLATTE
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State | LA
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Zip | 70586
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Country | US
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Telephone | 337-363-3560
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Fax | 337-363-3507
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Provider Business Mailing Address
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Address Line | 504 JACK MILLER ROAD SUITE 3
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City | VILLE PLATTE
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State | LA
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Zip | 70586
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Country | US
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Telephone | 337-363-3560
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Fax | 337-363-3507
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Authorized Official
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Title or Position | MD
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Name | DODANIM FRANCISCO ALTAMIRANO
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Credential |
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Telephone | 337-363-3560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 11525R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 193914
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License Number State | LA
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