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General NPI Number Information
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NPI Number | 1346890423
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Entity Type | Organization
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Legal Business Name | LA PETITE PEDIATRIC CLINIC
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 200 BEAULLIEU DR STE 7
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City | LAFAYETTE
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State | LA
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Zip | 70508-7230
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Country | US
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Telephone | 337-366-8616
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Fax | 337-366-8133
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Provider Business Mailing Address
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Address Line | 200 BEAULLIEU DR STE 7
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City | LAFAYETTE
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State | LA
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Zip | 70508-7230
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Country | US
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Telephone | 337-366-8616
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Fax | 337-366-8133
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Authorized Official
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Title or Position | OWNER
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Name | GENEVA MARIE GUIDRY LEJEUNE
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Credential | MD
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Telephone | 337-366-8616
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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 |
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License Number State |
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