OrganizationActive
Southern Pediatric Clinic
NPI 1104296417 · Health Service Clinic/Center · Oakdale, LA
Provider details
- NPI number
- 1104296417
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Stella Immanuel, Owner
- License
- MD12866R (LA)
Practice location
905 E 7th Ave
Suite 9
Oakdale, LA 71463-2797
Phone: (318) 215-8150
Fax: (318) 215-8151
Mailing address
905 E 7th Ave
Oakdale, LA 71463-2797
Registry dates
- Enumerated
- 2015-09-29
- Last updated
- 2015-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.