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Physicians Pediatrics Pediatric Gastroenterology

Provider NPI: 1720620784

Organization Information:
Organization is not Subpart
Authorized Official:  MARY JANE  WARD  SENIOR VP FINANCE  318-212-8951

Practice Location:
Tel: 318-212-5811  Fax: 318-212-5844

Business Mailing Address:
Tel: 318-212-5811  Fax: 318-212-5844

NPI Information:
NPI: 1720620784
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Pediatric Gastroenterology

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2080P0206X





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