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General NPI Number Information
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NPI Number | 1881861706
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Entity Type | Organization
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Legal Business Name | P. JOSHUA MAMMEN M.D. A.P.M.C
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 713 N EASTERN AVE
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City | CROWLEY
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State | LA
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Zip | 70526-3856
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Country | US
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Telephone | 337-788-2216
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Fax | 337-783-9407
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Provider Business Mailing Address
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Address Line | 711 N MONTGOMERY AVE
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City | KAPLAN
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State | LA
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Zip | 70548-2923
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Country | US
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Telephone | 337-643-1747
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Fax | 337-643-3707
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Authorized Official
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Title or Position | GENERAL SURGEON/OWNER
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Name | DR. JOSHUA P MAMMEN
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Credential | M.D.
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Telephone | 337-788-2216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 05428R
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License Number State | LA
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