Provider Demographics
NPI:1386771194
Name:ALL KIDS R US MEDICAL CLINIC, LLC
Entity type:Organization
Organization Name:ALL KIDS R US MEDICAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SATERFIEL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:318-388-5030
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71294-0685
Mailing Address - Country:US
Mailing Address - Phone:318-388-5030
Mailing Address - Fax:318-388-7134
Practice Address - Street 1:107 CONTEMPO AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5311
Practice Address - Country:US
Practice Address - Phone:318-388-5030
Practice Address - Fax:318-388-7134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448494Medicaid