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General NPI Number Information
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NPI Number | 1124256052
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Entity Type | Organization
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Legal Business Name | SONDES-FIDELIS OF LOUISIANA LLC
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 1016 1/2 W 21ST AVE
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City | COVINGTON
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State | LA
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Zip | 70433-7443
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Country | US
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Telephone | 985-792-0459
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 1/2 W 21ST AVE
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City | COVINGTON
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State | LA
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Zip | 70433-7443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | SCOTT SONDES
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Credential | MD
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Telephone | 985-792-0459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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