Kenneth P. Mauterer MD a Medical Corp

NPI #1205018017 in Olla, Louisiana

Provider Information

NPI Number: 1205018017
Entity Type: Organization
Organization Name: Kenneth P. Mauterer MD a Medical Corp
Primary Specialty: General Practice
Enumeration Date: Dec 4, 2007
Last Updated: Dec 4, 2007

Practice Location

Address: 1148 N PINE ROAD
City: Olla
State: Louisiana
ZIP Code: 71465
Phone: (318) 495-3131

Authorized Official

Name: DR. KENNETH P MAUTERER, MD
Title: PRESIDENT
Phone: (318) 495-3131

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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