| Organization Name: | ROGER D RHOLDON JR |
| NPI Number: | 1366860603 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLAIRE MELANCON (CREDENTIALING) |
| Mailing Address: | 6100 Cameron St Scott |
| State: | LA US |
| Postal Code: | 705835144 |
| Phone Number: | 3372896770 |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2014 |
| NPI Last Update Date: | 07/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | AP07699 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |