Kenneth P. Mauterer MD a Medical Corp

Organization Active NPI General Practice Physician · Olla, LA

NPI 1205018017 · NPPES record last updated Dec 4, 2007

Key facts

NPI
1205018017
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
License
012667 (LA)
Legal business name
KENNETH P. MAUTERER MD A MEDICAL CORP
Practice address
1148 N Pine Road
Olla, LA 71465
Phone
(318) 495-3131
Fax
(318) 495-3677
NPI assigned
Dec 4, 2007
Organization subpart
No

Authorized official

Name
Dr. Kenneth P Mauterer, MD
Title
President
Phone
(318) 495-3131

National Provider Directory

Locations

1148 N Pne Rd
Olla, LA 71480
Phone (318) 495-3175

1148 N Pne Rd
Olla, LA 71465

1148 N Pne Rd
Olla, LA 71480
Phone (318) 495-3175

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208D00000X 012667 LA Yes

Addresses

Primary practice location

1148 N Pine Road
Olla, LA 71465

Mailing address

PO Box 668
Olla, LA 71465-0668
Phone (318) 495-3131

Other providers in Olla, LA

All providers in Olla, LA · General Practice Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.