St Jude Medical Group LLC
NPI #1396086211 in Lake Charles, Louisiana
Provider Information
- NPI Number
- 1396086211
- Entity Type
- Organization
- Organization Name
- St Jude Medical Group LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Mar 4, 2013
- Last Updated
- Mar 4, 2013
Practice Location
- Address
- 4150 NELSON RD
- Address 2
- BLDG E SUITE 4
- City
- Lake Charles
- State
- Louisiana
- ZIP Code
- 70605-4148
- Phone
- (337) 564-6722
Authorized Official
- Name
- DR. JUDE AGENDIA, M.D.
- Title
- OWNER
- Phone
- (337) 564-6722
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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