Jefferson Pediatric Clinic

NPI #1972642197 in Marrero, Louisiana

Provider Information

NPI Number: 1972642197
Entity Type: Organization
Organization Name: Jefferson Pediatric Clinic
Primary Specialty: Pediatrics
Enumeration Date: Feb 5, 2007
Last Updated: Jun 17, 2008

Practice Location

Address: 1111 MEDICAL CENTER BLVD
Address 2: SUITE N-813
City: Marrero
State: Louisiana
ZIP Code: 70072-3151
Phone: (504) 349-6813

Authorized Official

Name: SCOTTY JAMES OUBRE
Title: OFFICE ASSISTANT
Phone: (504) 349-6813

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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