Cedar Lake Pediatric Clinic Pllc
NPI #1497826044 in Biloxi, Mississippi
Provider Information
- NPI Number
- 1497826044
- Entity Type
- Organization
- Organization Name
- Cedar Lake Pediatric Clinic Pllc
- Primary Specialty
- Pediatrics
- Enumeration Date
- Nov 13, 2006
- Last Updated
- Jul 12, 2007
Practice Location
- Address
- 1721 MEDICAL PARK DR STE 200
- City
- Biloxi
- State
- Mississippi
- ZIP Code
- 39532-2105
- Phone
- (228) 248-2572
Authorized Official
- Name
- DR. LISA J HALLER, MD
- Title
- OWNER
- Phone
- (228) 248-2572
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
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