Louisiana Dermatology Associates, LLC

NPI #1912190646 in Gonzales, Louisiana

Provider Information

NPI Number: 1912190646
Entity Type: Organization
Organization Name: Louisiana Dermatology Associates, LLC
Primary Specialty: Dermatology
Enumeration Date: Aug 27, 2007
Last Updated: Aug 27, 2007

Practice Location

Address: 1014 W. ST. CLARE BOULEVARD
Address 2: SUITE 1040
City: Gonzales
State: Louisiana
ZIP Code: 70737
Phone: (225) 743-2090

Authorized Official

Name: GLENDA IMES
Title: PRACTICE MANAGER
Phone: (225) 927-5663

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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