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General NPI Number Information
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NPI Number | 1164767877
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Entity Type | Organization
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Legal Business Name | MEDICAL RESOURCES & GUIDANCE, INC.
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Dates
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Enumeration Date | 12/06/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 5615 CORPORATE BLVD STE 600A
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City | BATON ROUGE
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State | LA
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Zip | 70808-2540
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Country | US
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Telephone | 337-363-4999
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Fax | 337-363-3702
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Provider Business Mailing Address
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Address Line | PO BOX 568
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City | VILLE PLATTE
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State | LA
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Zip | 70586-0568
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Country | US
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Telephone | 337-363-4999
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Fax | 337-363-3702
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | TAMMY KING FONTENOT
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Credential |
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Telephone | 337-363-4999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 27064
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License Number State | LA
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