CLHG-Ruston LLC
Organization Active NPI Pediatrics Physician · Ruston, LA
NPI 1477210342 · NPPES record last updated Nov 26, 2021
Key facts
- NPI
- 1477210342
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- CLHG-RUSTON LLC
- Practice address
- 401 E Vaughn Ave
Ruston, LA 71270-5950 - Phone
- (318) 254-2100
- NPI assigned
- Nov 26, 2021
- Organization subpart
- No
Authorized official
- Name
- Autumn Fulmer
- Title
- Director of Clinic Operations
- Phone
- (318) 372-2017
Corporate family (same tax ID) 8
National Provider Directory
- Tax ID family
- CLHG-Ruston LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
401 E Vaughn Ave
Ruston, LA 71270-5950
Mailing address
401 E Vaughn Ave
Ruston, LA 71270-5950
Other providers in Ruston, LA
- Jessica Granger Clark
- Danny Clay
- CLHG-Ruston LLC
- CLHG-Ruston LLC
- CLHG-Ruston LLC
- CLHG-Ruston LLC
- CLHG-Ruston LLC
- CLHG-Ruston LLC
- CLHG-Ruston LLC
- CLHG-Ruston LLC
All providers in Ruston, LA · Pediatrics Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.