Southern Pines Family Medical

NPI #1245326149 in Pearl River, Louisiana

Provider Information

NPI Number: 1245326149
Entity Type: Organization
Organization Name: Southern Pines Family Medical
Primary Specialty: Internal Medicine
Enumeration Date: Oct 5, 2006
Last Updated: Jun 8, 2011

Practice Location

Address: 64629 HIGHWAY 41
City: Pearl River
State: Louisiana
ZIP Code: 70452-3611
Phone: (985) 863-7100

Authorized Official

Name: DR. GLENN BUTT, M D
Title: MEMBER
Phone: (985) 863-7100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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