Paradise Children'S Clinic of Louisiana LLC

Organization Active NPI Pediatrics Physician · Ball, LA

NPI 1124457676 · NPPES record last updated Nov 22, 2021

Key facts

NPI
1124457676
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
PARADISE CHILDREN'S CLINIC OF LOUISIANA LLC
Practice address
4702 Monroe Hwy
Ball, LA 71405-3944
Phone
(318) 641-6113
Fax
(318) 641-6115
NPI assigned
Nov 5, 2013
Organization subpart
No

Authorized official

Name
Ashley L Mason
Title
Office Manager
Phone
(318) 641-6113

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

2226 Worley Dr
Alexandria, LA 71301
Phone (318) 443-9634

4702 Monroe Hwy
Ball, LA 71405
Phone (318) 640-9116

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
208000000X Yes
Family Nurse Practitioner
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
363LF0000X
Pediatric Nurse Practitioner
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
363LP0200X

Addresses

Primary practice location

4702 Monroe Hwy
Ball, LA 71405-3944

Mailing address

4702 Monroe Hwy
Ball, LA 71405-3944
Phone (318) 641-6113

Other practice location 1

5821 Monroe Hwy
Ball, LA 71405-3362
Phone (318) 641-6113

Other identifiers

IdentifierTypeStateIssuer
2351192MedicaidLA

Other names

  • Paradise Children's Clinic Doing business as

Other providers in Ball, LA

All providers in Ball, LA · Pediatrics Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.