Provider Demographics
NPI:1891892147
Name:CORNERSTONE PEDIATRICS,APMC
Entity Type:Organization
Organization Name:CORNERSTONE PEDIATRICS,APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MD
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:JEAN PRADOS
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-352-6464
Mailing Address - Street 1:1055 PARKWAY DR STE A
Mailing Address - Street 2:P. O. BOX 7253
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457
Mailing Address - Country:US
Mailing Address - Phone:318-352-6464
Mailing Address - Fax:318-352-2488
Practice Address - Street 1:1055 PARKWAY DR STE A
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457
Practice Address - Country:US
Practice Address - Phone:318-352-6464
Practice Address - Fax:318-352-2488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center