| Clhg-ruston Llc | |
|
401 E Vaughn Ave Ruston LA 71270-5950 | |
| (318) 254-2100 | |
| Not Available |
| Full Name | Clhg-ruston Llc |
|---|---|
| Speciality | Pediatrics |
| Location | 401 E Vaughn Ave, Ruston, Louisiana |
| Authorized Official Name and Position | Autumn Fulmer (DIRECTOR OF CLINIC OPERATIONS) |
| Authorized Official Contact | 3183722017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clhg-ruston Llc 401 E Vaughn Ave Ruston LA 71270-5950 Ph: () - | Clhg-ruston Llc 401 E Vaughn Ave Ruston LA 71270-5950 Ph: (318) 254-2100 |
| NPI Number | 1477210342 |
|---|---|
| Provider Enumeration Date | 11/26/2021 |
| Last Update Date | 11/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477210342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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