Pediatric Clinic of Northeast la a Medical Corporation

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC CLINIC OF NORTHEAST LA A MEDICAL CORPORATION

Practice address

1601 Lamy LN
Monroe, LA 71201-3735

Phone

(318) 387-3453

Fax

(318) 323-9045

NPI assigned

Dec 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Frances Meade O'Boyle

Title

President

Phone

(318) 325-0483

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1801070164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 DEAN CHAPEL RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712917609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 LAMY LN",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013735",
            "telephone_number": "318-387-3453",
            "fax_number": "318-323-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CLINIC OF NORTHEAST LA A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "O'BOYLE",
        "authorized_official_first_name": "FRANCES",
        "authorized_official_middle_name": "MEADE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-325-0483",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Monroe, LA
• Providers in Monroe, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.