Magnolia Pediatrics
Specialist in Prairieville, LA. Organization (NPI-2).
NPI number1477611556
StatusActive
Last updated in NPPESNov 6, 2018
Details
- NPI
- 1477611556
- Entity type
- Organization (NPI-2)
- Legal business name
- Magnolia Pediatrics
- Organization subpart
- No
- Enumeration date
- Dec 4, 2006
- Last updated
- Nov 6, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 045939 | LA | Yes |
Practice location
17038 Commerce Centre DrPrairieville, LA 70769-3483
Phone 225-744-4484 · Fax 225-677-9359
Mailing address
17038 Commerce Centre DrPrairieville, LA 70769-3483
Phone 225-744-4484 · Fax 225-677-9359
Authorized official
Lisa Hamner
Office Manager
2257444484
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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