NPI | 1043580624 |
---|---|
Doing Business As | DESOTO REGIONAL FAMILY MEDICINE-MANSFIELD |
Entity Type | Organization |
Authorized Contact | HALLIE DEUTSCH Credentialing Specialist 318-871-3101 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: LA 229RHC-3) |
Enumeration Date | 2012-01-12 |
Last Update Date | 2020-05-04 |