Kenneth P. Mauterer MD a Medical Corp

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

012667 Issued in 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

Last updated

Dec 4, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth P Mauterer, MD

Title

President

Phone

(318) 495-3131

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1205018017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "OLLA",
            "state": "LA",
            "postal_code": "714650668",
            "telephone_number": "318-495-3131",
            "fax_number": "318-495-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 N PINE ROAD",
            "city": "OLLA",
            "state": "LA",
            "postal_code": "71465",
            "telephone_number": "318-495-3131",
            "fax_number": "318-495-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH P. MAUTERER MD A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "MAUTERER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-495-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "LA",
            "license": "012667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hardtner Medical Center
• Hardtner Medical Center
• Tyler Kennedy Hinson, MD
• Carli Prudhomme Johnson, M.S., CCC-SLP
• Roy Steven Johnson, CRNA
• Lasalle Hospital Service Dist #1 (Hardtner Medical Center)
• Lasalle Hospital Service District #1 (Hardtner Medical Center)
• Lasalle Parish Hospital Service Dist No1 (Hardtner Medical Center)
• Lasalle Parish Hospital Service District #1 (Hardtner Medical Clinic)
• Lasalle Parish Hospital Service District #1 (Hardtner Medical Center)

• General Practice Physician in Olla, LA
• Providers in Olla, LA by specialty
• General Practice Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.