Provider Demographics
NPI:1467927723
Name:EUGENE AND OLEANDER LLC
Entity Type:Organization
Organization Name:EUGENE AND OLEANDER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:RAI
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-226-1606
Mailing Address - Street 1:1604 LICHESTER DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0503
Mailing Address - Country:US
Mailing Address - Phone:985-226-1606
Mailing Address - Fax:225-302-7015
Practice Address - Street 1:11715 BRICKSOME AVE STE A6
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2307
Practice Address - Country:US
Practice Address - Phone:225-246-7136
Practice Address - Fax:225-302-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty