| Lily Pad Pediatrics, LLC | |
|
153 Town Boulevard Opelousas LA 70570 | |
| (337) 942-4453 | |
| Not Available |
| Full Name | Lily Pad Pediatrics, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 153 Town Boulevard, Opelousas, Louisiana |
| Authorized Official Name and Position | Jackie Clark (BILLING MANAGER) |
| Authorized Official Contact | 3379424453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lily Pad Pediatrics, LLC 153 Town Boulevard Opelousas LA 70570 | Lily Pad Pediatrics, LLC 153 Town Boulevard Opelousas LA 70570 Ph: (337) 942-4453 |
| NPI Number | 1073969531 |
|---|---|
| Provider Enumeration Date | 05/13/2016 |
| Last Update Date | 04/02/2024 |
| Certification Date | 04/02/2024 |
| Medicare PECOS PAC ID | 7911348784 |
|---|---|
| Medicare Enrollment ID | O20240510000494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073969531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (NU) | Primary |
| 208000000X | Pediatrics | (NU) | Secondary |
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